Evidence to Practice: Bridging the Gap in Environmental Challenges (Cold, Heat, Hypoxia) in Sport and Exercise: Acclimatization/Acclimation, Training, Competitions, Recovery, Rehabilitation and Therapeutic Interventions

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Introduction: Training intensity and nutrition may influence adaptations to training performed in hypoxia and consequently performance outcomes at altitude. This study investigates if performance at simulated altitude is improved to a larger extent when high-intensity interval training is performed in normobaric hypoxia and if this is potentiated when combined with chronic dietary nitrate (NO3) supplementation.

Methods: Thirty endurance-trained male participants were allocated to one of three groups: hypoxia (13% FiO2) + NO3; hypoxia + placebo; and normoxia (20.9% FiO2) + placebo. All performed 12 cycling sessions (eight sessions of 2*6 × 1 min at severe intensity with 1 min recovery and four sessions of 4*6*10 s all-out with 20 s recovery) during a 4-week period (three sessions/week) with supplementation administered 3–2.5 h before each session. An incremental exhaustion test, a severe intensity exercise bout to exhaustion (Tlim) and a 3 min all-out test (3AOT) in hypoxia (FiO2 = 13%) with pulmonary oxygen uptake ( V ˙ O2), V ˙ O2 kinetics, and changes in vastus lateralis local O2 saturation (SmO2) measured were completed by each participant before and after training.

Results: In all tests, performance improved to the same extent in hypoxia and normoxia, except for SmO2 after Tlim (p = 0.04, d = 0.82) and 3AOT (p = 0.03, d = 1.43) which were lower in the two hypoxic groups compared with the normoxic one. Dietary NO3 supplementation did not bring any additional benefits.

Conclusion: Performance at simulated altitude was not improved to a larger extent when high-intensity interval training was undertaken in normobaric hypoxic conditions, when compared with normoxic training. Additionally, dietary NO3 supplementation was ineffective in further enhancing endurance performance at simulated altitude.

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Frontiers in Physiology

Physiological and Pathological Responses to Hypoxia and High Altitude, Volume III
Edited by Rodrigo Iturriaga, David Cristóbal Andrade, Tatum S. Simonson
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21 March 2025
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