Introduction Elite cross-country (XC) skiers undergo standardized testing to monitor their performance development and to calibrate training prescriptions. However, the long-term progression of performance indicators, such as maximal oxygen uptake (VO2max), performance at the second lactate threshold (LT2), and time-trial performance over an athlete's career remains unclear. This study aimed to investigate the longitudinal data from > 15 years of exercise testing with the Swiss XC ski national team to examine the trajectories of key performance indicators across the careers of male and female skiers. Methods The longitudinal development of VO2max, LT2, and 24-minute double poling performance (24-min DP), described in further detail elsewhere (Bucher et al., 2023), was analyzed in 72 male and 49 female current and former Swiss XC-ski national team athletes. The performance trajectories were modeled using mixed-effects approaches, with a linear random intercept for VO2max, a linear random slope for LT2, and a third-degree polynomial for 24-min DP. Fixed effects included age, sex, and their interaction, with random effects at the individual level. The study included 357 observations (n = 27 females, 48 males) for VO2max, 911 (n = 46 females, 65 males) for LT2, and 601 (n = 49 females, 70 males) for 24-min DP. Results VO2max in females tended to increase by 0.16 mL/kg/min per year (p=0.085), with no increase in males (0.03 ml/kg/min, p=0.627). Males had a higher baseline VO2max at age 18 (70.8 vs. 58.2 mL/kg/min, 21.6% difference), but the rate of change with age was not significantly different between the sexes (p=0.259). LT2 improved significantly with age for both sexes: females gained 0.038 W/kg per year (p<0.001) and males 0.052 W/kg per year (p<0.001). At age 18, males had a 23.2% higher baseline LT2 (3.34 vs. 2.71 W/kg). In the 24-min DP test, both sexes initially improved significantly (p<0.001). However, there was a notable decrease in the rate of improvement in males, as indicated by the quadratic age term (p<0.001). On the other hand, females showed a consistent linear performance trajectory throughout their careers, with no significant quadratic age term (p=0.430). Female skiers showed a baseline performance of 3820 m at age 18, while this value was at 4788 m in males, with males outperforming females by 968 m (25.3%). Discussion/Conclusion VO₂max, LT2, and 24-min DP showed distinct developmental trajectories across age and sex in elite XC skiers. While VO₂max remained unchanged, LT2 continuously increased throughout their career. On the other hand, 24-min DP followed a non-linear progression in males, with a slowdown in performance improvement as they transitioned from the U23 to the senior age category. These results highlight the importance of high initial VO₂max at the junior level and the greater trainability of LT2 and aerobic time-trial performance with the accumulation of specific training as athletes progress in their careers. References Bucher, E., Millet, G. P., Wehrlin, J. P., & Steiner, T. (2023). Test-retest reliability of ski-specific aerobic, sprint, and neuromuscular performance tests in highly trained cross-country skiers. Scandinavian Journal of Medicine and Science in Sports, 33, 2482–2498. https://doi.org/10.1111/sms.14473

Athletes use hypoxic living and training to increase hemoglobin mass (Hbmass), but Hbmass declines rapidly upon return to sea level. We investigated whether intermittent hypoxic exposure (IHE) + continuous hypoxic training (CHT) after return to sea level maintained elevated Hbmass, and if changes in Hbmass were transferred to changes in maximal oxygen uptake (V̇o2max) and exercise performance. Hbmass was measured in 58 endurance athletes before (PRE), after (POST1), and 30 days after (POST2) a 27 ± 4-day training camp in hypoxia (n = 44, HYP) or at sea level (n = 14, SL). After returning to sea level, 22 athletes included IHE (2 h rest) + CHT (1 h training) in their training every third day for 1 mo (HYPIHE + CHT), whereas the other 22 HYP athletes were not exposed to IHE or CHT (HYPSL). Hbmass increased from PRE to POST1 in both HYPIHE + CHT (4.4 ± 0.7%, means ± SE) and HYPSL (4.1 ± 0.6%) (both P < 0.001). Compared with PRE, Hbmass at POST2 remained 4.2 ± 0.8% higher in HYPIHE + CHT (P < 0.001) and 1.9 ± 0.5% higher in HYPSL (P = 0.023), indicating a significant difference between the groups (P = 0.002). In SL, no significant changes were observed in Hbmass with mean alterations between -0.5% and 0.4%. V̇o2max and time to exhaustion during an incremental treadmill test (n = 35) were elevated from PRE to POST2 only in HYPIHE + CHT (5.8 ± 1.2% and 5.4 ± 1.4%, respectively, both P < 0.001). IHE + CHT possesses the potential to mitigate the typical decline in Hbmass commonly observed during the initial weeks after return to sea level.NEW & NOTEWORTHY Sets of 2-h intermittent hypoxic exposure + 1-h continuous hypoxic training, every third day, possess the potential to mitigate the typical decline in Hbmass that is commonly observed during the initial weeks after return to sea level from an altitude camp. Inclusion of IHE + CHT in the training regimen was also accompanied by improvements in V̇o2max and exercise performance in most but not all Tier 3-Tier 5 level endurance athletes during the training season.

Purpose: Laboratory tests are commonly performed by cross-country (XC) skiers due to the challenges of obtaining reliable performance indicators on snow. However, only a few studies have reported reliability data for ski-specific test protocols. Therefore, this study examined the test-retest reliability of ski-specific aerobic, sprint, and neuromuscular performance tests. Methods: Thirty-nine highly trained XC skiers (26 men and 13 women, age: 22 +/- 4 years, VO2max: 70.1 +/- 4.5 and 58.8 +/- 4.4 mL center dot kg(-1)center dot min(-1), respectively) performed two test trials within 6 days of a diagonal VO2max test, n = 27; skating graded exercise test to assess the second lactate threshold (LT2), n = 27; 24-min double poling time trial (24-min DP, n = 25), double poling sprint test (Sprint(DP1), n = 27), and 1-min self-paced skating sprint test (Sprint(1-min), n = 26) using roller skis on a treadmill, and an upper-body strength test (UB-ST, n = 27) to assess peak power (P-peak) with light, medium, and heavy loads. For each test, the coefficient of variation (CV), intraclass correlation coefficient (ICC), and minimal detectable change (MDC) were calculated. Results: VO2max demonstrated good-to- excellent reliability (CV = 1.4%; ICC = 0.99; MDC = 112 mL center dot min(-1)), whereas moderate-to- excellent reliability was found for LT2 (CV = 3.1%; ICC = 0.95). Performance during 24-min DP, SprintDP1, and Sprint1- min showed good-to- excellent reliability (CV = 1.0%-2.3%; ICC = 0.96-0.99). Absolute reliability for UB-ST Ppeak was poor (CV = 4.9%-7.8%), while relative reliability was excellent (ICC = 0.93-0.97) across the loads. Conclusion: In highly trained XC skiers, sport-specific aerobic and sprint performance tests demonstrated high test-retest reliability, while neuromuscular performance for the upper body was less reliable. Using the presented protocols, practitioners can assess within-and between-season changes in relevant performance indicators.

Introduction When exercising in the cold, optimizing thermoregulation is essential to maintain performance. However, no study has investigated thermal parameters with wearable-based measurements in a field setting among elite Nordic skiers. Therefore, this study aimed to assess the thermal response and sensation measured at different body parts during exercise in a cold environment in biathletes. Methods Thirteen Swiss national team biathletes (6 females, 7 males) performed two skiing bouts in the skating technique on two consecutive days (ambient temperature: −3.74 ± 2.32 °C) at 78 ± 4% of maximal heart rate. Heat flux (HF), core (Tcore) and skin (Tskin) temperature were measured with sensors placed on the thigh, back, anterior and lateral thorax. Thermal sensation (TS) was assessed three times for different body parts: in protective winter clothing, in a race suit before (PRE) and after exercise (POST). Results HF demonstrated differences (p < 0.001) between sensor locations, with the thigh showing the highest heat loss (344 ± 37 kJ/m2), followed by the back (269 ± 6 kJ/m2), the lateral thorax (220 ± 47 kJ/m2), and the anterior thorax (192 ± 37 kJ/m2). Tcore increased (p < 0.001). Tskin decreased for all body parts (p < 0.001). Thigh Tskin decreased more than for other body parts (p < 0.001). From PRE to POST, TS of the hands decreased (p < 0.01). Conclusion Biathletes skiing in a race suit at moderate intensity experience significant heat loss and a large drop in Tskin, particularly at the quadriceps muscle. To support the optimal functioning of working muscles, body-part dependent differences in the thermal response should be considered for clothing strategy and for race suit design.

ABSTRACTEndurance athletes attribute performance not only to physiological factors, but also refer to psychological factors such as motivation. The goal of this study was to quantify the proportion of the variance in endurance performance that is explained by psychological factors in addition to the physiological factor VO2max. Twenty‐five athletes of the U17 Swiss Cycling national team (7f, 18 m, 15.3 ± 0.5 years) were examined in a cross‐sectional study with psychological factors and VO2max as independent variables and endurance performance in road cycling as dependent variable. Questionnaires were used to assess psychological factors (i.e. use of mental techniques, self‐compassion, mental toughness, achievement motivation, and action vs. state orientation). VO2max was measured by a step incremental cycle ergometer test of exhaustion. Endurance performance was measured in a cycling mountain time trial (1,320 m long, incline of 546 meters). A multiple regression model was created by using forward selection of regression model predictors. Results showed that higher VO2max values (β = .48), being male (β = .26), and higher achievement motivation (i.e. perseverance, β = .11) were associated with a better endurance performance. A more frequent use of one particular mental technique (i.e. relaxation techniques, β = .03) was associated with a worse endurance performance. Our study shows that a physiological factor like VO2max explains endurance performance to a large extent but psychological factors account for additional variance. In particular, one aspect of achievement motivation, namely perseverance, was associated with a better endurance performance. HIGHLIGHTS Endurance performance is explained by physiological (e.g. VO2max) and psychological (e.g. perseverance) factors VO2max explains young cyclists’ endurance performance to a large extent Perseverance explained performance beyond the influence of VO2max

Recently, a new automated carbon monoxide (CO) rebreathing method (aCO) to estimate haemoglobin mass (Hbmass) was introduced. The aCO method uses the same CO dilution principle as the widely used optimised CO rebreathing method (oCO). The two methods differ in terms of CO administration, body position, and rebreathing time. Whereas with aCO, CO is administered automatically by the system in a supine position of the subject, with oCO, CO is administered manually by an experienced operator with the subject sitting. Therefore, the aim of this study was to quantify possible differences in Hbmass estimated with the two methods. Hbmass was estimated in 18 subjects (9 females, 9 males) with oCO using capillary blood samples (oCOc) and aCO taking simultaneously venous blood samples (aCOv) and capillary blood samples (aCOc). Overall, Hbmass was different between the three measurement procedures (F = 57.55, p < .001). Hbmass was lower (p < .001) for oCOc (737 g ± 179 g) than for both aCOv (825 g ± 189 g, -9.3%) and aCOc (835 g ± 189 g, -10.6%). There was no difference in Hbmass estimated with aCOv and aCOc procedures (p = .12). Three factors can likely explain the 10% difference in Hbmass: differences in calculations (including a factor for myoglobin flux), body position (distribution of CO in blood circulation) during rebreathing, and time of blood sampling. Moreover, the determination of Hbmass with aCO is possible with capillary blood sampling instead of venous blood sampling.

We recently measured the development of hemoglobin mass (Hbmass) in 10 Swiss national team endurance athletes between ages 16–19. Level of Hbmass at age 16 was an important predictor for Hbmass and endurance performance at age 19. The aim was to determine how many of these young athletes were still members of Swiss national teams (NT) at age 25, how many already terminated their career (TC), and whether Hbmass at ages 16 and 19 was different between the NT and TC group. We measured Hbmass using the optimized carbon monoxide re-breathing technique in 10 high-performing endurance athletes every 0.5 years beginning at age 16 and ending at age 19. At age 25, two athletes were in the NT group and eight athletes in the TC group. Mean absolute, body weight-, and lean body mass (LBM) related Hbmass at age 16 was 833 ± 61 g, 13.7 ± 0.2 g/kg and 14.2 ± 0.2 g/kg LBM in the NT group and 742 ± 83 g, 12.2 ± 0.7 g/kg and 12.8 ± 0.8 g/kg LBM in the TC group. At age 19, Hbmass was 1,042 ± 89 g, 14.6 ± 0.2 g/kg and 15.4 ± 0.2 g/kg LBM in the NT group and 863 ± 109 g, 12.7 ± 1.1 g/kg and 13.5 ± 1.1 g/kg LBM in the TC group. Body weight- and LBM related Hbmass were higher in the NT group than in the TC group at ages 16 and 19 (p < 0.05). These results indicate, that Hbmass at ages 16 and 19 possibly could be an important predictor for later national team membership in endurance disciplines.

PURPOSE:It is unknown, whether endurance training stimulates hemoglobin mass (Hbmass) and maximal oxygen uptake (V˙O2max) increases during late adolescence. Therefore, this study assessed the influence of endurance training on Hbmass, blood volume parameters, and V˙O2max in endurance athletes and control subjects from age 16 to 19 yr. METHODS:Hemoglobin mass, blood volume parameters, V˙O2max and anthropometric parameters were measured in male elite endurance athletes from age 16 to 19 yr in 6-month intervals (n = 10), as well as in age-matched male controls (n = 12). RESULTS:Neither the level of Hbmass per lean body mass (LBM) (P = 0.80) nor the development of Hbmass during the 3 yr (P = 0.97) differed between athletes and controls. Hbmass at age 16 yr was 13.24 ± 0.89 g·kg LBM and increased by 0.74 ± 0.58 g·kg LBM (P < 0.01) from age 16 to 19 yr. There was a high correlation between Hbmass at age 16 and 19 yr (r = 0.77; P < 0.001). Plasma volume, blood volume, and V˙O2max were higher in athletes compared to controls (P < 0.05). Blood volume and V˙O2max increased with age (P < 0.01, similarly in both groups). CONCLUSIONS:Endurance training volumes do not explain individual differences in Hbmass levels nor Hbmass and V˙O2max development in the age period from 16 to 19 yr. The higher V˙O2max levels of athletes may be partially explained by training-induced higher plasma and blood volumes, as well as other training adaptations. Since Hbmass at age 16 yr varies substantially and the development of Hbmass in late adolescence is comparably small and not influenced by endurance training, Hbmass at age 16 yr is an important predictor for Hbmass at adult age and possibly for the aptitude for high-level endurance performance.

The rim width of cross-country mountain bike wheel sets has increased in recent years, but the effect of this increase on performance remains unknown. The aim of this study was to analyse the influence of rim width on rolling resistance and off-road speed. We compared 3 tubeless wheel sets: 25 mm inner width as baseline, 30 mm width with the same tyre stiffness, and 30 mm width with the same tyre pressure. Three riders conducted 75 rolling resistance tests for each wheel set on a cross-country course. We determined rolling resistance using the virtual elevation method and calculated off-road speeds for flat and uphill conditions using a mathematical model. Baseline rolling resistance (Cr) was 0.0298, 90% CI [0.0286, 0.0310], which decreased by 1.4%, [0.7, 2.2] with the wider rim and the same tyre stiffness and increased by 0.9%, [0.1, 1.6] with the wider rim and the same tyre pressure. The corresponding effects on off-road speed were most likely trivial (0.0% to 0.7% faster and 0.1% to 0.6% slower, respectively). Because the effect of rim width on off-road speed seems negligible, athletes should choose the rim width that offers the best bike handling and should experiment with low tyre pressures.

Shooting in biathlon competitions substantially influences final rankings, but the predictability of hits and misses is unknown. The aims of the current study were A) to explore factors influencing biathlon shooting performance and B) to predict future hits and misses. We explored data from 118,300 shots from 4 seasons and trained various machine learning models before predicting 34,340 future shots (in the subsequent season). A) Lower hit rates were discovered in the sprint and pursuit disciplines compared to individual and mass start (P<0.01, h=0.14), in standing compared to prone shooting (P<0.01, h=0.15) and in the 1(st) prone and 5(th) standing shot (P<0.01, h=0.08 and P<0.05, h=0.05). B) A tree-based boosting model predicted future shots with an area under the ROC curve of 0.62, 95% CI [0.60, 0.63], slightly outperforming a simple logistic regression model and an artificial neural network (P<0.01). The dominant predictor was an athlete's preceding mode-specific hit rate, but a high degree of randomness persisted, which complex models could not substantially reduce. Athletes should focus on overall mode-specific hit rates which epitomise shooting skill, while other influences seem minor.

New Findings What is the central question of this study? It has been assumed that athletes embarking on an ‘live high–train low’ (LHTL) camp with already high initial haemoglobin mass (Hb mass ) have a limited ability to increase their Hb mass further post‐intervention. Therefore, the relationship between initial Hb mass and post‐intervention increase was tested with duplicate Hb mass measures and comparable hypoxic doses in male athletes. What is the main finding and its importance? There were trivial to moderate inverse relationships between initial Hb mass and percentage Hb mass increase in endurance and team‐sport athletes after the LHTL camp, indicating that even athletes with higher initial Hb mass can reasonably expect Hb mass gains post‐LHTL. It has been proposed that athletes with high initial values of haemoglobin mass (Hb mass ) will have a smaller Hb mass increase in response to ‘live high–train low’ (LHTL) altitude training. To verify this assumption, the relationship between initial absolute and relative Hb mass values and their respective Hb mass increase following LHTL in male endurance and team‐sport athletes was investigated. Overall, 58 male athletes (35 well‐trained endurance athletes and 23 elite male field hockey players) undertook an LHTL training camp with similar hypoxic doses (200–230 h). The Hb mass was measured in duplicate pre‐ and post‐LHTL by the carbon monoxide rebreathing method. Although there was no relationship ( r = 0.02, P = 0.91) between initial absolute Hb mass (in grams) and the percentage increase in absolute Hb mass , a moderate relationship ( r = −0.31, P = 0.02) between initial relative Hb mass (in grams per kilogram) and the percentage increase in relative Hb mass was detected. Mean absolute and relative Hb mass increased to a similar extent ( P ≥ 0.81) in endurance (from 916 ± 88 to 951 ± 96 g, +3.8%, P < 0.001 and from 13.1 ± 1.2 to 13.6 ± 1.1 g kg −1 , +4.1%, P < 0.001, respectively) and team‐sport athletes (from 920 ± 120 to 957 ± 127 g, +4.0%, P < 0.001 and from 11.9 ± 0.9 to 12.3 ± 0.9 g kg −1 , +4.0%, P < 0.001, respectively) after LHTL. The direct comparison study using individual data of male endurance and team‐sport athletes and strict methodological control (duplicate Hb mass measures and matched hypoxic dose) indicated that even athletes with higher initial Hb mass can reasonably expect Hb mass gain post‐LHTL.

Although a low rolling resistance is advantageous in mountain bike cross-country racing, no studies have used the virtual elevation method to compare tyres from different manufacturers as used in international competitions so far. The aims of this study were to assess the reliability of this method, to compare the off-road rolling resistance between tyres and to calculate the influence on off-road speed. Nine 29- in. mountain bike cross-country tyres were tested on a course representing typical ground surface conditions 5 or 6 times. The coefficient of rolling resistance was estimated with the virtual elevation method by 3 investigators and corresponding off-road speeds were calculated. The virtual elevation method was highly reliable (typical error = 0.0006, 2.8%; limits of agreement < 0.0005, r >= 0.98). The mean coefficient of rolling resistance was 0.0219 and differed from 0.0205 to 0.0237 (P < 0.001) between tyres. The calculated differences in off-road speed amounted to 2.9-3.2% (0% slope) and 2.3-2.4% (10% slope) between the slowest and the fastest tyre. The reliability of the method and the differences in rolling resistance between the tyres illustrate the value of testing tyres for important competitions on a representative ground surface using the virtual elevation method.

The aim of this study was to compare the accuracy among a high number of current mobile cycling power meters used by elite and recreational cyclists against a first principle-based mathematical model of treadmill cycling. 54 power meters from 9 manufacturers used by 32 cyclists were calibrated. While the cyclist coasted downhill on a motorised treadmill, a back-pulling system was adjusted to counter the downhill force. The system was then loaded 3 times with 4 different masses while the cyclist pedalled to keep his position. The mean deviation (trueness) to the model and coefficient of variation (precision) were analysed. The mean deviations of the power meters were -0.9±3.2% (mean±SD) with 6 power meters deviating by more than±5%. The coefficients of variation of the power meters were 1.2±0.9% (mean±SD), with Stages varying more than SRM (p<0.001) and PowerTap (p<0.001). In conclusion, current power meters used by elite and recreational cyclists vary considerably in their trueness; precision is generally high but differs between manufacturers. Calibrating and adjusting the trueness of every power meter against a first principle-based reference is advised for accurate measurements.

The purpose of this research was to compare individual hemoglobin mass (Hbmass) changes following a live high-train low (LHTL) altitude training camp under either normobaric hypoxia (NH) or hypobaric hypoxia (HH) conditions in endurance athletes. In a crossover design with a one-year washout, 15 male triathletes randomly performed two 18-day LHTL training camps in either HH or NH. All athletes slept at 2,250 meters and trained at altitudes <1,200 meters. Hbmass was measured in duplicate with the optimized carbon monoxide rebreathing method before (pre) and immediately after (post) each 18-day training camp. Hbmass increased similarly in HH (916-957 g, 4.5 ± 2.2%, P < 0.001) and in NH (918-953 g, 3.8 ± 2.6%, P < 0.001). Hbmass changes did not differ between HH and NH (P = 0.42). There was substantial interindividual variability among subjects to both interventions (i.e., individual responsiveness or the individual variation in the response to an intervention free of technical noise): 0.9% in HH and 1.7% in NH. However, a correlation between intraindividual ΔHbmass changes (%) in HH and in NH (r = 0.52, P = 0.048) was observed. HH and NH evoked similar mean Hbmass increases following LHTL. Among the mean Hbmass changes, there was a notable variation in individual Hbmass response that tended to be reproducible.NEW & NOTEWORTHY This is the first study to compare individual hemoglobin mass (Hbmass) response to normobaric and hypobaric live high-train low using a same-subject crossover design. The main findings indicate that hypobaric and normobaric hypoxia evoked a similar mean increase in Hbmass following 18 days of live high-train low. Notable variability and reproducibility in individual Hbmass responses between athletes was observed, indicating the importance of evaluating individual Hbmass response to altitude training.

The main aim of the present study was to quantify the magnitude of differences introduced when estimating a given blood volume compartment (e.g. plasma volume) through the direct determination of another compartment (e.g. red cell volume) by multiplication of venous haematocrit and/or haemoglobin concentration. However, since whole body haematocrit is higher than venous haematocrit such an approach might comprise certain errors. To test this experimentally, four different methods for detecting blood volumes and haemoglobin mass (Hb(mass)) were compared, namely the carbon monoxide (CO) re-breathing (for Hb(mass)), the indocyanine green (ICG; for plasma volume [PV]) and the sodium fluorescein (SoF; for red blood cell volume [RBCV]) methods. No difference between ICG and CO re-breathing derived PV could be established when a whole body/venous haematocrit correction factor of 0.91 was applied (p=0.11, r=0.43, mean difference -340 +/- 612mL). In contrast, when comparing RBCV derived by the CO re-breathing and the SoF method, the SoF method revealed lower RBCV values as compared to the CO re-breathing method (p<0.05, r=0.95, mean difference -728 +/- 184mL). However, compared to the ICG and the SoF methods, the typical error (%TE) and hence reliability of the CO re-breathing method was lower for all measured parameters. Therefore, estimating blood volume compartments by the direct assessment of another compartment can be considered a suitable approach. The CO re-breathing method proved accurate in determining the induced phlebotomy and is at the same time judged easier to perform than any of the other methods.

Background: The aims of the present study were to investigate the impact of three whole blood donations on endurance capacity and hematological parameters and to determine the duration to fully recover initial endurance capacity and hematological parameters after each donation.Methods: Twenty-four moderately trained subjects were randomly divided in a donation (n = 16) and a placebo (n = 8) group. Each of the three donations was interspersed by 3 months, and the recovery of endurance capacity and hematological parameters was monitored up to 1 month after donation.Results: Maximal power output, peak oxygen consumption, and hemoglobin mass decreased (p < 0.001) up to 4 weeks after a single blood donation with a maximal decrease of 4, 10, and 7%, respectively. Hematocrit, hemoglobin concentration, ferritin, and red blood cell count (RBC), all key hematological parameters for oxygen transport, were lowered by a single donation (p < 0.001) and cumulatively further affected by the repetition of the donations (p < 0.001). The maximal decrease after a blood donation was 11% for hematocrit, 10% for hemoglobin concentration, 50% for ferritin, and 12% for RBC (p < 0.001). Maximal power output cumulatively increased in the placebo group as the maximal exercise tests were repeated (p < 0.001), which indicates positive training adaptations. This increase in maximal power output over the whole duration of the study was not observed in the donation group.Conclusions: Maximal, but not submaximal, endurance capacity was altered after blood donation in moderately trained people and the expected increase in capacity after multiple maximal exercise tests was not present when repeating whole blood donations.

Fore more than a decade, the live high-train low (LHTL) approach, developed by Levine and Stray-Gundersen, has been widely used by elite endurance athletes. Originally, it was pointed out, that by living at moderate altitude, athletes should benefit from an increased red cell volume (RCV) and hemoglobin mass (Hb(mass)), while the training at low altitudes should prevent the disadvantage of reduced training intensity at moderate altitude. VO2max is reduced linearly by about 6-8 % per 1000 m increasing altitude in elite athletes from sea level to 3000 m, with corresponding higher relative training intensities for the same absolute work load. With 2 weeks of acclimatization, this initial deficit can be reduced by about one half. It has been debated during the last years whether sea-level training or exposure to moderate altitude increases RCV and Hb(mass) in elite endurance athletes. Studies which directly measured Hb(mass) with the optimized CO-rebreathing technique demonstrated that Hb(mass) in endurance athletes is not influenced by sea-level training. We documented that Hb(mass) is not increased after 3 years of training in national team cross-country skiers. When athletes are exposed to moderate altitude, new studies support the argument that it is possible to increase Hb(mass) temporarily by 5-6 %, provided that athletes spend >400 h at altitudes above 2300-2500 m. However, this effect size is smaller than the reported 10-14 % higher Hb(mass) values of endurance athletes living permanently at 2600 m. It remains to be investigated whether endurance athletes reach these values with a series of LHTL camps.

PurposeTo compare hemoglobin mass (Hb(mass)) changes during an 18-d live high-train low (LHTL) altitude training camp in normobaric hypoxia (NH) and hypobaric hypoxia (HH).MethodsTwenty-eight well-trained male triathletes were split into three groups (NH: n = 10, HH: n = 11, control [CON]: n = 7) and participated in an 18-d LHTL camp. NH and HH slept at 2250 m, whereas CON slept, and all groups trained at altitudes <1200 m. Hb(mass) was measured in duplicate with the optimized carbon monoxide rebreathing method before (pre-), immediately after (post-) (hypoxic dose: 316 vs 238 h for HH and NH), and at day 13 in HH (230 h, hypoxic dose matched to 18-d NH). Running (3-km run) and cycling (incremental cycling test) performances were measured pre and post.ResultsHb(mass) increased similar in HH (+4.4%, P < 0.001 at day 13; +4.5%, P < 0.001 at day 18) and NH (+4.1%, P < 0.001) compared with CON (+1.9%, P = 0.08). There was a wide variability in individual Hb(mass) responses in HH (-0.1% to +10.6%) and NH (-1.4% to +7.7%). Postrunning time decreased in HH (-3.9%, P < 0.001), NH (-3.3%, P < 0.001), and CON (-2.1%, P = 0.03), whereas cycling performance changed nonsignificantly in HH and NH (+2.4%, P > 0.08) and remained unchanged in CON (+0.2%, P = 0.89).ConclusionHH and NH evoked similar Hb(mass) increases for the same hypoxic dose and after 18-d LHTL. The wide variability in individual Hb(mass) responses in HH and NH emphasizes the importance of individual Hb(mass) evaluation of altitude training.

Purpose: We investigated the changes in physiological and performance parameters after a Live High-Train Low (LHTL) altitude camp in normobaric (NH) or hypobaric hypoxia (HH) to reproduce the actual training practices of endurance athletes using a crossover-designed study. Methods: Well-trained triathletes (n = 16) were split into two groups and completed two 18-day LTHL camps during which they trained at 1100–1200 m and lived at 2250 m (PiO2 = 111.9 ± 0.6 vs. 111.6 ± 0.6 mmHg) under NH (hypoxic chamber; FiO2 18.05 ± 0.03%) or HH (real altitude; barometric pressure 580.2 ± 2.9 mmHg) conditions. The subjects completed the NH and HH camps with a 1-year washout period. Measurements and protocol were identical for both phases of the crossover study. Oxygen saturation (SpO2) was constantly recorded nightly. PiO2 and training loads were matched daily. Blood samples and VO2max were measured before (Pre-) and 1 day after (Post-1) LHTL. A 3-km running-test was performed near sea level before and 1, 7, and 21 days after training camps. Results: Total hypoxic exposure was lower for NH than for HH during LHTL (230 vs. 310 h; P < 0.001). Nocturnal SpO2 was higher in NH than in HH (92.4 ± 1.2 vs. 91.3 ± 1.0%, P < 0.001). VO2max increased to the same extent for NH and HH (4.9 ± 5.6 vs. 3.2 ± 5.1%). No difference was found in hematological parameters. The 3-km run time was significantly faster in both conditions 21 days after LHTL (4.5 ± 5.0 vs. 6.2 ± 6.4% for NH and HH), and no difference between conditions was found at any time. Conclusion: Increases in VO2max and performance enhancement were similar between NH and HH conditions.