Effect of Endurance Training and Altitude Training on Hemoglobin Mass and Sea Level Endurance Performance
Jon Peter Wehrlin, PhD Head Endurance Group, Section for Elite Sport, Swiss Federal Institute of Sports, Magglingen, Switzerland
Swiss Federal Institute of Sport, (University of Applied Sciences), Magglingen => Section for Elite Sport (Collaboration with Swiss Olympic Association)
Elite Sport Performance diagnosis Research & Development
Teaching - Bachelor - Master Elite Sport (Since 2008) - Coaches Education -Sport medicine education Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Endurance Physiology Group
Sandra Lauenstein MSc, 50%. OL, Biathlon, MTB
Kellie PrichardAnna Hauser Peschek, PhD, MSc, 100%. 100%. Schwimming PhD Student
Severin Trösch, BSc ETH, 100%. Athletics
Beat Müller EHSM, 60%. Coach Swiss Cycling. MTB, Biathlon
Thomas Steiner PhD, 100%. XC Skiing, Triathlon
Jon Peter Wehrlin PhD, 100%. Head Endurance Physiology Group
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Endurance sport: VO2max - Possible limiting factors
Lung diffusion capacity Heart capacity
Oxygen transport capacity Muscle capacity Bassett DR and Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000; 32: 70-84. Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Relationship between hemoglobin mass and VO2max
Schmidt & Prommer Exerc Sport Scie Rev, 2010
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Endurance Sport: Blood Doping…
..can move you from f 30th place l to t the th podium… di Stray-Gundersen J, Videman T, Penttilä L, Lereim I. Abnormal hematologic profiles in elite cross-country Skiers: blood doping or? Clin J Sports Med, 2003, 132-7
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Importance of the hemoglobin mass: Blood doping
Switzerland
USA
Spain
Denmark
‌..etc.
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Increase in Red cell volume (Hemoglobin mass) with rhEPO Doping
Lundby et al., J Physiol, 2007 Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Key Questions for elite endurance athletes:
1)
Does hemoglobin mass increase with normal training? - Training camp (Peaking and Tapering) - Training Season - Several years endurance training - Differences: Adolescence vs adulthood - „Responder – Nonresponder“ => Talent diagnosis
2)
Does Hbmass increase with altitude training (LHTL)? - „Hypoxic dose“? - „Individual response“? (Swiss Projects)
3)
Is performance after LHTL altitude training increased? - Competitions at sea level (Swiss Projects)
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Background: Classic blood parameter (hematocrit and hemoglobin)
Hematocrit (Hct; %) Percent red blood cells Men ca. 45% (Critical value men 50%)
Hemoglobin (Hb; g/dl) Mean value ca. 15g/dl / (critical value 17g/dl) Red color in red blood cells, Binds the oxygen Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Background: Classical blood paramters Hb 15g/dl
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Hematocrit: 44%
Blood volume (liteers) Blutvolum e n [Lite r]
8 7 6
Hb 15g/dl Hematocrit: 44%
5 4 3
Blood plasma
2 1
Blood plasma
Red cell vol. Red cell vol.
0 Untrained
XC skier
Problem: We do not know how the absolute values are! Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Background: Classical blood paramters
Hb (g/dl) and Hct (%): Effects of changes in plasma volume 7
Hct 43% Hct 45%
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Hct 47%
Blood volume (L)
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Important factors: - Position: (horizontal = ↓ vs vertical = Hct ↑ - Hydratation status (low = Hct ↑; high ↓)
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- Training (acute = Hct ↑; after = Hct ↓)
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- Altitude: (acute = Hct ↑)
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- Heat: (acute = Hct ↑; chronic↓ )
1
0
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Background: Classic blood parameter (hematocrit) Effect of drinking one liter of saline solution on hematocrit value 50 49 48 47
Hematocrit (%)
46 45 44 43 42 41 40 39 38 37 0 -15
-5 Before5
15
25
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Time (Minutes)
Modified after Schmidt W. et al. Int J Sports Med, 21: 133-138; 2000 Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Background: Measurement of blood volume parameters
Blood volume: 8000 ml
Hemoglobin mass:
Red cell volume:
Plasma volume:
3520 ml
4480 ml
1256 g
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Background: Measurement of hemoglobin mass
=> Total amount of hemoglobin in g
CO
O2
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Key Questions for elite endurance athletes
1)
Does hemoglobin mass increase with normal training? - Training camp (Peaking and Tapering) - Training Season - Several years endurance training - Differences: Adolescence vs adulthood? - „Responder – Nonresponder“ => Talent diagnosis?
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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1)
Does hemoglobin mass increase with normal training?
22 21
Hem moglobin mass (g/kg bodyweight)
20 19 9
Untrained subjects (28 +/-5 years Triathletes (German National Elite; 30 +/- 5 years) Runners (German National Elite; 24 +/- 6 years) Cycling (German Elite Professional Team; 27 +/- 3 years)
18 17 16 15 14 13 12
Key question:
+ 40%
Effect of „training“ or„talent“? or„talent ?
11 10 9 0
Modified after Heinicke et al. Int J Sports Med, 2001 Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Does hemoglobin mass increase with normal training? Training camp
1400 1300
Hemoglobin mass
1200
4 Weeks training in the heat 4 Weeks training at sea level 4 Weeks training at 1300m 4 Weeks training at 1740m
1100 1000 900 800 700 600 500 0
Modified after Gore et al., Int J Sports Med, 1997 Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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1)
Does hemoglobin mass increase with normal training? During a training season
Prommer: Hbmass showed very low oscillations during a training year (<6%)
Prommer et al. Med Sci Sports & Exercise, 2008
ď&#x192;&#x17E; Garvican et al. measured Hb mass in 10 elite Cyclists during 2-10 months: CV was 3.3% (Range 2.4.4%)
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Does hemoglobin mass increase with normal training? Several years of training 19
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13
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12
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11
0
0
1500
Hemoglob bin mass (g)
Hemoglobin m mass (g/kg)
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17
1500
P = 0.29
1400
1400
1300
1300
1200
1200
1100
1100
1000
1000
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900
800
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700
0
Hemoglob bin mass (g)
Hemoglobin ma ass (g/kg)
P = 0.87
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0 2004
2007
Wehrlin, J.P., HallĂŠn J. Marti B. Hypoxia Symposium, 2009, Chateau Lake Louise, Alberta, Canada) Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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1)
Does hemoglobin mass increase with normal training? Several years of training
Observation in routine hemoglobin mass measurement: Elite athletes show no big changes in hemoglobin mass with normal training Possible to use it as “talent identification marker” in adolesence?
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Does hemoglobin mass increase with normal training?
Wehrlin & Clénin ECSS, 2008 Federal Office of Sport, Magglingen, Switzerland
Steiner & Wehrlin. Med Sci Sports & Exercise, 2011 22
Jon Peter Wehrlin, PhD, Section for Elite Sport
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1)
Does hemoglobin mass increase with normal training?
Wehrlin & ClĂŠnin ECSS, 2008
Steiner & Wehrlin. Med Sci Sports & Exercise, 2011
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
1)
Does hemoglobin mass increase with normal training?
Wehrlin & ClĂŠnin ECSS, 2008 Federal Office of Sport, Magglingen, Switzerland
Steiner & Wehrlin. Med Sci Sports & Exercise, 2011 24
Jon Peter Wehrlin, PhD, Section for Elite Sport
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1)
Does hemoglobin mass increase with normal training? Several years of training in adolesence 16
Controls Hemoglobin mass (g/kg bodyweig ght)
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14
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„Responder B“ (low level)
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„Nonresponder“
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10 16
16.5
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17.5
18.5
18
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Age (years)
Wehrlin & Steiner unpubl. data Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Does hemoglobin mass increase with normal training? Several years of training in adolesence 16
Hemoglobin mass (g/kg bodyweight) H
Athletes 15
„Responder R d A“ (high level)
14
13
„Responder B“ (low level)
12
„Nonresponder“
11
10 16
16.5
17
17.5 Age (years)
Federal Office of Sport, Magglingen, Switzerland
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18.5
19
Wehrlin & Steiner unpubl. data 26
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1)
Does hemoglobin mass increase with normal training?
Conclusion I: It seems like in elite endurance athletes (age > 20 y), we observe no substantial increase in Hbmass with normal training camps or several months of endurance training. However, it is possible to increase Hbmass moderately over several years. We do not know the reasons for this. Conclusion II: In adolescent endurance athletes and controls (age between 16 and 20), we can observe a relevant increase in hemoglobin mass . However, However these effects seem to be individually different but are not affected by endurance training amount.
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Key Questions for elite endurance athletes
2)
Does hemoglobin mass increase with altitude training (LHTL)?
Federal Office of Sport, Magglingen, Switzerland
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2) Does hemoglobin mass increase with altitude training (LHTL)? Hypoxic dose? 30 Laitinen et al. 1995 (Abstract only; n=7Runners; LHTL; Simulated altitude: 2500m; 20-28 days; CG) Svedenhag et al. 1997 (n=7 XC-skiers; LHTH; Real altitude: 1900m; 30 days; EB) Levine et al. 1997 (n=13 Runners; LHTH; Real altitude: 2500m; 28 days; CG; EB) Levine et al. 1997 (n=13 Runners; LHTL; Real altitude: 2500m; 28 days; CG; EB) Gore et al. 1998 (n=8 Cyclists; LHTH; Real altitude: 2690m; 31 days; CO) Rusko et al. 1999 (Abstract only; n=10 XC-Skiers/Triathletes; LHTL; Simulated altitude: 2500m; 25 days; CG; CO) Ashenden et al. 1999b (n=7 Runners; LHTL; Simulated altitude: 2650m; 12 days; CG; CO) Ashenden et al. 1999a (n=6 Cyclists/Triathletes/XC-skiers; LHTL; Simulated altitude:3000m; 23 days; CG; CO) Dehnert et al. 2002 (n=11 Triathletes; LHTL; Real altitude: 1956m; 14 days; CG; CO) Saunders et al. 2004 (n=10 Runners; LHTL; Simulated altitude: 2000-3100m; 20 days; CG; CO) Friedmann et al. 2005 (n=16 Junior swimmers; LHTH; Real altitude: 2100-2300m; 21 days; CO) Heinicke et al. 2005 (n=10 Biathletes; LHTH; Real altitude: 2050; 21 days; CO) Brugniaux et al. 2006 (n=5; LHTL; Simulated altitude: 2500-3000m/1200m; 18 days; CG; CO) Robach et al. 2006 (n=9 Swimmers; LHTL; Simulated altitude: 2500-3000m/1200m; 13 days; CG; CO) Robach et al. 2006 (n=6 XC-skiers; LHTL; Simulated altitude: 2500-3500m/1200m; 18 days; CG; CO) Wehrlin & Marti 2006 (n=2 Runners; LHTL; Real altitude: 2456/1800m; 26 days; CO) Wehrlin et al. 2006 (n=10 Orienteers; LHTL; Real altitude: 2456m/1800m/1000m; 23 days; CG; CO) Neya et al. 2007 (n=10 runners; LHTL; Simulated altitude: 3000m; 29 days; CO) Pottgiesser et al. 2008 (n=7 Cyclists; LHTH; Real altitude: 1816m; 21 days; CO) Saunders et al. 2009 (n=9 Runners; LHTL; Simulated altitude: 2860m; 46 days; CO) Wehrlin et al. 2009 (Submitted; n=7; Cross-country skiers; LHTL; Real altitude: 2590m; 21 days; CG) Clark et al. 2010 (n=12 cyclists; LHTL; Simulated altitude: 3000m)
28 26 24 22 20
/ RCV (%)
18 16
Change in Hb
mass
14 12
+ 1% per 100h at 2500m (maximum about 5-10%)
C
E
10
B
8 6 4
A
2
D
0 -2 -4 0
100
200
300
400
500
600
700
800
Time in hypoxia (hours) Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
2) Does hemoglobin mass increase with altitude training (LHTL)? Individual Response?
1100 1080
1040 1020
+ 4%
1000 980
940 920
Truth
960 Truth
Hemoglobin mass (g)
1060
900 880 0 Pre Altitude
Federal Office of Sport, Magglingen, Switzerland
Post Altitude
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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2) Does hemoglobin mass increase with altitude training (LHTL)? Individual Response?
1100 1080
1040
+ 4%
1020
+ 0%
1000
920
Truth
940
Measured
960
Measured
980
Truth
Hemoglobin mass (g)
1060
900 880 0 Post Altitude
Pre Altitude
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
2) Does hemoglobin mass increase with altitude training (LHTL)? Individual Response?
1100 1080
1040
+ 0%
1020 1000 980
940 920
Truth
960 Truth
Hemoglobin mass (g)
1060
900 880 0 Pre Altitude
Federal Office of Sport, Magglingen, Switzerland
Post Altitude
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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2) Does hemoglobin mass increase with altitude training (LHTL)? Individual Response?
1100 1080
+ 4%
1020
+ 0%
1000
920
Truth
940
Measured
960
Measured
980
Truth
Hemoglobin mass (g)
1060 1040
900 880 0 Post Altitude
Pre Altitude
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
2) Does hemoglobin mass increase with altitude training (LHTL)? Individual Response?
1100 1080 3 weeks at 1800m (St. Moritz Switzerland)
1020 1000
920
Measurement II
940
Measurement I
960
+ 2.2% Measurement II
980
Measurement I
Hemoglobin mass (g)
1060 1040
900 880 0 Pre Altitude
Federal Office of Sport, Magglingen, Switzerland
Post Altitude
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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2) Does hemoglobin mass increase with altitude training (LHTL)? Conclusion: Hemoglobin mass can increase with „Live high – train low“ or „Live Live high – train high“ altitude training => The effects seems to be dependent of the „hypoxic dose“ => We recommend to spend at least 400h at an altitude of about 2500m (2300- 2800) to reach a relevant increase of about 5% in hemoglobin mass => We recommend to measure the individual response with „Double Double measurements of Hbmass before and after Altitude Training Camp
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Key Questions for elite endurance athletes
3)
Is performance after LHTL altitude training at sea level increased?
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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3)
Is performance after LHTL altitude training increased? => Keep in Mind:
Millet et al., Sports Med, 2010 (modified after Reiss) Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
3)
Is performance after LHTL altitude training increased? => Keep in Mind:
Range: + 0.5 to + 6% Peaking
Tapering
Mujica 2009
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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3)
Is performance after LHTL altitude training increased?
=> In summary, natural LHTL currently provides the best protocol for enhancing endurance performance in elite and subelite athletes Bonetti & Hopkins, Sea level Exercise performance following adaptation to Hypoxia, Sports Med, 2009
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
=> Statistical significance versus practical relevance?
Viktor Rรถthlin Swiss Marathon
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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2010: 1. Place, European Championships Barcelona
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Live at 2307m
Live at 2307m
Train at 1800m
Train at 1800m
Marathon at the European Championships
Train at 400m
Train at 400m
Barcelona (Spain)
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Weeks Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
Swiss altitude project for the 2012 London Olympic games: Mountainbike
2010
Altitude Training â&#x20AC;&#x17E;Best Practiceâ&#x20AC;&#x153;
2011
Individual Adaptations
2012
Olympic Games
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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3
Full Test 25.6.2010 Full Test 24.6.2010
Full Test 14.6.2010 Full Test 15.6.2010
Full Test 17.5.2010 Full Test 18.5.2010
Altitude group Control group
Target II T
Target I
2
1
25.5 - 13.6.2010
European Championships Haifa 7.7. - 11.7.2010 23-28 days after LHTL)
Full Test 2.7.2010
Weeks after LHTL
Full Test 1.7.2010
LHTL Bernina Hospiz
C2 Flims? 3.7.2010
C1 Engelberg ? 20.6.2010
World Cup/C1 Chambéry 6.6.2010
C1 Plaffeien 30.5.2010
22./23.5.2010 2
World Cup Offenburg W
World Cup
1./2.5.2010
World W Cup Houffalize 5./6.6.10?
World Cup / C1
Swiss altitude project for the 2012 London Olympic games: Mountainbike
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
3)
Is performance after LHTL altitude training increased?
Conclusion: It seems that performance after „Live high – train low“ altitude training can be g However, this is more increased than it would have been with normal training. really hard to prove… => natural LHTL currently provides the best protocol for enhancing endurance performance in elite and subelite athletes
=> However, altitude training is not a „magic bullet“, there are also risks ((overtraining, g ilness etc))
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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Thankâ&#x20AC;&#x2DC;s for your attention!
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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=> United States Olympic Committee (USOC) Altit de Training S Altitude Symposium, mposi m 2013 2013, October 9th â&#x20AC;&#x201C; 11th Colorado Springs, Colorado
Federal Office of Sport, Magglingen, Switzerland
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Jon Peter Wehrlin, PhD, Section for Elite Sport
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