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Ida A. Heikura, Louise M. Burke, Dan Bergland, Arja L.T. Uusitalo, Antti A. Mero and Trent Stellingwerff

change in hemoglobin mass (Hbmass) is considered an objective and relatively easily measured outcome of altitude exposure within a standardized altitude training protocol, with a typical increase of 2% to 5% being reported following a block of altitude training. 3 – 7 However, the mechanisms associated

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Torben Pottgiesser, Laura A. Garvican, David T. Martin, Jesse M. Featonby, Christopher J. Gore and Yorck O. Schumacher

Hemoglobin mass (tHb) is considered to be a main factor for sea-level performance after “live high–train low” (LHTL) altitude training, but little research has focused on the persistence of tHb following cessation of altitude exposure. The aim of the case study was to investigate short-term effects of various hematological measures including tHb upon completion of a simulated altitude camp. Five female cyclists spent 26 nights at simulated altitude (LHTL, 16.6 ± 0.4 h/d, 3000 m in an altitude house) where tHb was measured at baseline, at cessation of the camp, and 9 d thereafter. Venous blood measures (hemoglobin concentration, hematocrit, %reticulocytes, serum erythropoietin, ferritin, lactate dehydrogenase, and haptoglobin) were determined at baseline; on day 21 during LHTL; and at days 2, 5, and 9 after LHTL. Hemoglobin mass increased by 5.5% (90% confidence limits [CL] 2.5 to 8.5%, very likely) after the LHTL training camp. At day 9 after simulated LHTL, tHb decreased by 3.0% (90%CL −5.1 to −1.0%, likely). There was a substantial decrease in serum EPO (−34%, 90%CL −50 to −12%) at 2 d after return to sea level and a rise in ferritin (23%, 90%CL 3 to 46%) coupled with a decrease in %reticulocytes (−23%, 90%CL −34 to −9%) between day 5 and 9 after LHTL. Our findings show that following a hypoxic intervention with a beneficial tHb outcome, there may be a high probability of a rapid tHb decrease upon return to normoxic conditions. This highlights a rapid component in red-cell control and may have implications for the appropriate timing of altitude training in relation to competition.

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Charles R. Pedlar, Gregory P. Whyte, Richard Burden, Brian Moore, Gill Horgan and Noel Pollock

This case study examines the impact of low serum ferritin (sFe) on physiological assessment measures and performance in a young female 1500-m runner undertaking approximately 95–130 km/wk training. The study spans 4 race seasons and an Olympic Games. During this period, 25 venous blood samples were analyzed for sFe and hemoglobin (Hb); running economy, VO2max, and lactate threshold were measured on 6 occasions separated by 8–10 mo. Training was carefully monitored including 65 monitored treadmill training runs (targeting an intensity associated with the onset of blood lactate accumulation) using blood lactate and heart rate. Performances at competitive track events were recorded. All data were compared longitudinally. Mean sFe was 24.5 ± 7.6 μg/L (range 10–47), appearing to be in gradual decline with the exception of 2 data points (37 and 47 μg/L) after parenteral iron injections before championships, when the lowest values tended to occur, coinciding with peak training volumes. Each season, 1500-m performance improved, from 4:12.8 in year 1 to 4:03.5 in year 4. VO2max (69.8 ± 2.0 mL · kg−1 · min−1) and running economy (%VO2max at a fixed speed of 16 km/h; max 87.8%, min 80.3%) were stable across time and lactate threshold improved (from 14 to 15.5 km/h). Evidence of anemia (Hb <12 g/dL) was absent. These unique data demonstrate that in 1 endurance athlete, performance can continue to improve despite an apparent iron deficiency. Raising training volume may have caused increased iron utilization; however, the effect of this on performance is unknown. Iron injections were effective in raising sFe in the short term but did not appear to affect the long-term pattern.

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Mitsuo Neya, Taisuke Enoki, Nao Ohiwa, Takashi Kawahara and Christopher J. Gore


To quantify the changes of hemoglobin mass (Hbmass) and maximum oxygen consumption (VO2max) after 22 days training at 1300–1800 m combined with nightly exposure to 3000-m simulated altitude. We hypothesized that with simulated 3000-m altitude, an adequate beneficial dose could be as little as 10 h/24 h.


Fourteen male collegiate runners were equally divided into 2 groups: altitude (ALT) and control (CON). Both groups spent 22 days at 1300–1800 m. ALT spent 10 h/night for 21 nights in simulated altitude (3000 m), and CON stayed at 1300 m. VO2max and Hbmass were measured twice before and once after the intervention. Blood was collected for assessment of percent reticulocytes (%retics), serum erythropoietin (EPO), ferritin, and soluble transferrin receptor (sTfR) concentrations.


Compared with CON there was an almost certain increase in absolute VO2max (8.6%, 90% confidence interval 4.8–12.6%) and a likely increase in absolute Hbmass (3.5%; 0.9–6.2%) at postintervention. The %retics were at least very likely higher in ALT than in CON throughout the 21 nights, and sTfR was also very likely higher in the ALT group until day 17. EPO of ALT was likely higher than that of CON on days 1 and 5 at altitude, whereas serum ferritin was likely lower in ALT than CON for most of the intervention.


Together the combination of the natural and simulated altitude was a sufficient total dose of hypoxia to increase both Hbmass and VO2max.

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Tiago Turnes, Rafael Penteado dos Santos, Rafael Alves de Aguiar, Thiago Loch, Leonardo Trevisol Possamai and Fabrizio Caputo

Purpose: To compare the intensity and physiological responses of deoxygenated hemoglobin breaking point ([HHb]BP) and anaerobic threshold (AnT) during an incremental test and to verify their association with 2000-m rowing-ergometer performance in well-trained rowers. Methods: A total of 13 male rowers (mean [SD] age = 24 [11] y and V˙O2peak = 63.7 [6.1] mL·kg−1·min−1) performed a step incremental test. Gas exchange, vastus lateralis [HHb], and blood lactate concentration were measured. Power output, V˙O2, and heart rate of [HHb]BP and AnT were determined and compared with each other. A 2000-m test was performed in another visit. Results: No differences were found between [HHb]BP and AnT in the power output (236 [31] vs 234 [31] W; Δ = 0.7%), 95% confidence interval [CI] 6.7%), V˙O2 (4.2 [0.5] vs 4.3 [0.4] L·min−1; Δ = −0.8%, 95% CI 4.0%), or heart rate (180 [16] vs 182 [12] beats·min−1; Δ = −1.6%, 95% CI 2.1%); however, there was high typical error of estimate (TEE) and wide 95% limits of agreement (LoA) for power output (TEE 10.7%, LoA 54.1–50.6 W), V˙O2 (TEE 5.9%, LoA −0.57 to 0.63 L·min−1), and heart rate (TEE 2.4%, LoA −9.6 to 14.7 beats·min−1). Significant correlations were observed between [HHb]BP (r = .70) and AnT (r = .89) with 2000-m mean power. Conclusions: These results demonstrate a breaking point in [HHb] of the vastus lateralis muscle during the incremental test that is capable of distinguishing rowers with different performance levels. However, the high random error would compromise the use of [HHb]BP for training and testing in rowing.

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Stephen J. Carter, Eric P. Plaisance, Gordon Fisher, Jose R. Fernandez, Barbara A. Gower and Gary R. Hunter

African American (AA) and European American (EA) women often exhibit differences in hemoglobin (Hb) and 25-hydroxyvitamin D [25(OH)D], both of which can be altered by calorie restriction leading to weight loss. Given these known differences, it is of clinical interest to examine the potential for race-specific, adverse responses to weight loss. Sixty-four overweight (BMI 27–29.9 kg/m2), premenopausal women consumed a standardized, very-low calorie diet to reduce BMI < 25 kg/m2. Ancestry informative markers provided estimates of African admixture, an objective mean of expressing race. Blood sampling and anthropometric measures were performed at baseline and upon meeting target BMI. At baseline, in the overweight state, Hb (g/dL) (AA, 11.7 ± 0.9 vs. EA, 12.5 ± 0.8; p < .01) and 25(OH)D (nmol/L) (AA, 35.7 ± 12.9 vs. EA, 57.0 ± 20.0; p < .01) were lower in AAs. After weight loss, Hb decreased (AA, -0.5 ± 0.7 vs. EA, -0.4 ± 0.6; p = .48) to a similar extent among races. Conversely, 25(OH)D increased (AA, 43.4 ± 14.0 vs. EA 68.2 ± 24.3; p < .01) though the magnitude of change (Δ) was not different (AA, +7.8 ± 13.5 vs. EA, +11.2 ± 16.7; p = .37) between races. Multiple linear regression revealed a positive association between ΔHb and Δ25(OH)D (r = .386; p < .01) adjusted for African admixture, Δtestosterone, and Δbody fat%. Path analyses revealed a significant indirect effect of Δbody fat% on ΔHb through Δ25(OH)D, β =-0.023, CI [-0.06, -0.004]. Following 15% weight loss, participants with the largest increase in serum 25(OH)D exhibited the smallest decrease in Hb. Future research should clarify the optimal degree of calorie restriction to stimulate weight loss while mitigating the potential risk of anemia associated with dieting efforts.

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Thaiz Mattos Sureira, Olga Silverio Amancio and Josefina Aparecida Pellegrini Braga

This study evaluates the relationship between body iron losses and gains in artistic gymnastics female athletes. It shows that despite the low iron intake and exercise-induced hemolysis, iron deficiency or iron-deficiency anemia does not occur, but partial changes in the hematological profile do. The hypothesis that gymnasts’ nutritional behavior contributes to anemia, which may be aggravated by exercise-induced hemolysis, led to this cross-sectional study, conducted with 43 female artistic gymnasts 6–16 yr old. The control group was formed by 40 nontraining girls, paired by age. Hemogram, serum iron, ferritin, soluble transferrin receptor, haptoglobin, total and fractional bilirubin, Type I urine, and parasitologic and occult fecal blood tests were evaluated. The athletes presented mean hematimetric and serum iron values (p = .020) higher than those of the control group. The bilirubin result discarded any hemolytic alteration in both groups. The haptoglobin results were lower in the athlete group (p = .002), confirming the incidence of exercise-induced hemolysis. Both groups presented low iron intake. The results suggest that artistic gymnastics practice leads to exerciseinduced hemolysis and partially changes the hematological profile, although not causing iron deficiency or iron-deficiency anemia, even in the presence of low iron intake.

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Sareen S. Gropper, L. Michelle Sorrels and Daniel Blessing

Copper status was assessed in 70 female collegiate athletes aged 18 to 25 years participating in cross country track, tennis, softball, swimming, soccer, basketball, and gymnastics during the 2000–2001 season. A group of 8 college-aged females, 20 to 23 years of age, who were not collegiate athletes, served as controls. Mean copper intakes including supplements did not differ significantly among the controls and athletic teams. Mean copper intakes including supplements as micrograms/day and percent recommended dietary allowance (RDA) were as follows: controls 1071 ± 772 μg (119 ± 86%), cross country track 1468 ± 851 μg (163 ± 95%), tennis 1099 ± 856 μg (122 ± 95%), softball 654 ± 420 μg (73 ± 47%), swimming 1351 ± 1060 μg (150 ± 118%), soccer 695 ± 368 μg (77 ± 41%), and gymnastics 940 ± 863 μg (104 ± 96%). Forty-one percent of athletes and 29% of controls failed to consume two thirds of the RDA for copper. Mean serum copper and ceruloplasmin concentrations were within the normal range and did not differ significantly among the controls (117 ± 22 μg/dl, 445 ± 122 μg/L) and cross country track (98 ± 17 μg/dl, 312 ± 59 μg/L), tennis (140 ± 84 μg/dl, 424 ± 244 μg/L), softball (95 ± 30 μg/dl, 310 ± 77 μg/L), swimming (98 ± 25 μg/dl, 312 ± 40 μg/L), soccer (93 ± 15 μg/dl, 324 ± 54 μg/ L), basketball (85 ± 10 μg/dl, 280 ± 62 μg/L), and gymnastics (96 ± 21 μg/dl, 315 ± 68 μg/L) teams. Copper status of female collegiate athletes appears to be adequate in this cross-sectional assessment.

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Kelly A. Brock, Lindsey E. Eberman, Richard H. Laird IV, David J. Elmer and Kenneth E. Games

compared with rest. Therefore, the purpose of this study was to examine the acute effects of a single SPC treatment on lower-extremity hemoglobin concentration in healthy participants. Methods Research Design We utilized a single cohort, repeated-measures design to analyze the change scores between

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Ben J. Lee and Charles Douglas Thake

treadmill speed to increase V ˙ O 2 and thus the cardiorespiratory response at a given level of BWS may not be appropriate in all rehabilitation scenarios. An alternative approach to elevate physiological stress at a given level of BWS is to reduce O 2 availability, thus reducing arterial hemoglobin O 2