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Sally P. Waterworth, Connor C. Spencer, Aaron L. Porter, and James P. Morton

, deliberately commencing and/or recovering from training sessions with reduced carbohydrate (CHO) availability (the so-called train-low paradigm) increases markers of mitochondrial biogenesis ( Hansen et al., 2005 ; Morton et al., 2009 ; Yeo et al., 2008 ) and both whole-body and intramuscular lipid oxidation

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Amelia J. Carr, Laura A. Garvican-Lewis, Brent S. Vallance, Andrew P. Drake, Philo U. Saunders, Clare E. Humberstone, and Christopher J. Gore

performing hypoxic training sessions. 15 Simulated (SIM) live high:train low altitude training presents an alternative to NAT, 2 , 16 whereby athletes train at or near sea level, but live and sleep in an hypoxic environment, 17 using altitude tents or similar modalities. 16 With SIM, all training is

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Erin L. McCleave, Katie M. Slattery, Rob Duffield, Philo U. Saunders, Avish P. Sharma, Stephen Crowcroft, and Aaron J. Coutts

.4161/temp.29800 10.4161/temp.29800 8. Buchheit M , Racinais S , Bilsborough J , et al . Adding heat to the live-high train-low altitude model: a practical insight from professional football . Br J Sports Med . 2013 ; 47 ( suppl 1 ): i59 – i69 . PubMed ID: 24282209 doi:10.1136/bjsports-2013

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Louise M. Burke, John A. Hawley, Asker Jeukendrup, James P. Morton, Trent Stellingwerff, and Ronald J. Maughan

coaches/athletes. For example, the term “train low” has been used to describe a single acute training session in which the availability of muscle CHO and/or exogenous CHO has been manipulated to “lower” levels before and/or during the session by a variety of techniques that have different metabolic and

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Isabella Russo, Paul A. Della Gatta, Andrew Garnham, Judi Porter, Louise M. Burke, and Ricardo J.S. Costa

Previously defined “train-low, compete-high” training protocols exploit these diverse roles by reducing carbohydrate availability during and (or) after training sessions that deplete muscle glycogen content (eg, approximately 2-h high-intensity interval training [HIIT]) to enhance training adaptations (eg

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Randall L. Wilber

“Live high-train low” (LH+TL) altitude training allows athletes to “live high” for the purpose of facilitating altitude acclimatization, as characterized by a significant and sustained increase in endogenous erythropoietin and subsequent increase in erythrocyte volume, while simultaneously enabling them to “train low” for the purpose of replicating sea-level training intensity and oxygen flux, thereby inducing beneficial metabolic and neuromuscular adaptations. In addition to natural/terrestrial LH+TL, several simulated LH+TL devices have been developed including nitrogen apartments, hypoxic tents, and hypoxicator devices. One of the key issues regarding the practical application of LH+TL is what the optimal hypoxic dose is that is needed to facilitate altitude acclimatization and produce the expected beneficial physiological responses and sea-level performance effects. The purpose of this review is to examine this issue from a research-based and applied perspective by addressing the following questions: What is the optimal altitude at which to live, how many days are required at altitude, and how many hours per day are required? It appears that for athletes to derive the hematological benefits of LH+TL while using natural/terrestrial altitude, they need to live at an elevation of 2000 to 2500 m for >4 wk for >22 h/d. For athletes using LH+TL in a simulated altitude environment, fewer hours (12-16 h) of hypoxic exposure might be necessary, but a higher elevation (2500 to 3000 m) is required to achieve similar physiological responses.

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Abigail S.L. Stickford, Daniel P. Wilhite, and Robert F. Chapman

Investigations into ventilatory, metabolic, and hematological changes with altitude training have been completed; however, there is a lack of research exploring potential gait-kinematic changes after altitude training, despite a common complaint of athletes being a lack of leg "turnover" on return from altitude training.


To determine if select kinematic variables changed in a group of elite distance runners after 4 wk of altitude training.


Six elite male distance runners completed a 28-d altitude-training intervention in Flagstaff, AZ (2150 m), following a modified “live high–train low” model, wherein higherintensity runs were performed at lower altitudes (945–1150 m) and low-intensity sessions were completed at higher altitudes (1950–2850 m). Gait parameters were measured 2–9 d before departure to altitude and 1 to 2 d after returning to sea level at running speeds of 300–360 m/min.


No differences were found in ground-contact time, swing time, or stride length or frequency after altitude training (P > .05).


Running mechanics are not affected by chronic altitude training in elite distance runners. The data suggest that either chronic training at altitude truly has no effect on running mechanics or completing the live high–train low model of altitude training, where higher-velocity workouts are completed at lower elevations, mitigates any negative mechanical adaptations that may be associated with chronic training at slower speeds.

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Alannah K. A. McKay, Ida A. Heikura, Louise M. Burke, Peter Peeling, David B. Pyne, Rachel P.L. van Swelm, Coby M. Laarakkers, and Gregory R. Cox

Sleeping with low carbohydrate (CHO) availability is a dietary strategy that may enhance training adaptation. However, the impact on an athlete’s health is unclear. This study quantified the effect of a short-term “sleep-low” dietary intervention on markers of iron regulation and immune function in athletes. In a randomized, repeated-measures design, 11 elite triathletes completed two 4-day mixed cycle run training blocks. Key training sessions were structured such that a high-intensity training session was performed in the field on the afternoon of Days 1 and 3, and a low-intensity training (LIT) session was performed on the following morning in the laboratory (Days 2 and 4). The ingestion of CHO was either divided evenly across the day (HIGH) or restricted between the high-intensity training and LIT sessions, so that the LIT session was performed with low CHO availability (LOW). Venous blood and saliva samples were collected prior to and following each LIT session and analyzed for interleukin-6, hepcidin 25, and salivary immunoglobulin-A. Concentrations of interleukin-6 increased acutely after exercise (p < .001), but did not differ between dietary conditions or days. Hepcidin 25 increased 3-hr postexercise (p < .001), with the greatest increase evident after the LOW trial on Day 2 (2.5 ± 0.9 fold increase ±90% confidence limit). The salivary immunoglobulin-A secretion rate did not change in response to exercise; however, it was highest during the LOW condition on Day 4 (p = .046). There appears to be minimal impact to markers of immune function and iron regulation when acute exposure to low CHO availability is undertaken with expert nutrition and coaching input.

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Amelia J. Carr, Philo U. Saunders, Laura A. Garvican-Lewis, and Brent S. Vallance

for competitions held at either altitude or sea level. 2 Live high:train low (LHTL) has also been used extensively, either by traveling to lower elevations to train 3 or by utilizing simulated altitude environments (altitude houses or tents) and training at sea level. 1 The effects of altitude

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Philo U. Saunders, Richard D. Telford, David B. Pyne, Christopher J. Gore, and Allan G. Hahn

We quantified the effect of an extended live high-train low (LHTL) simulated altitude exposure followed by a series of training camps at natural moderate altitude on competitive performance in seven elite middle-distance runners (Vo2max 71.4 ± 3.4 mL·min−1·kg−1, mean ± SD). Runners spent 44 ± 7 nights (mean ± SD) at a simulated altitude of 2846 ± 32 m, and a further 4 X 7- to 10-d training at natural moderate altitude (1700–2200 m) before racing. The combination of simulated LHTL and natural altitude training improved competitive performance by 1.9% (90% confidence limits, 1.3-2.5%). Middle-distance runners can confidently use a combination of simulated and natural altitude to stimulate adaptations responsible for improving performance.