RESEARCH: Studies reviewed this week: 13 September 2021 to 19 September 2021

ALTITUDE: Individual variation in response to altitude training

In recent weeks I've been sharing studies on altitude training. One of things that I've learnt over this time has been the individual response to altitude and how broad the range of effects can be on different athletes. This study started with the premise that "although the mean improvement in group response with this "high-low" training model is clear, the individual response displays a wide variability" and they sought to find the factors that contribute to this variability.

The authors found that:

In the retrospective analysis, responders displayed a significantly larger increase in erythropoietin (Epo) concentration after 30 h at altitude compared with nonresponders. After 14 days at altitude, Epo was still elevated in responders but was not significantly different from sea-level values in nonresponders.
Nonresponders demonstrated a significant slowing of interval-training velocity at altitude and thus achieved a smaller O2 consumption during those intervals, compared with responders.
In conclusion, after a 28-day altitude training camp, a significant improvement in 5,000-m run performance is, in part, dependent on 1) living at a high enough altitude to achieve a large acute increase in Epo, sufficient to increase the total red cell volume and V(O2)max, and 2) training at a low enough altitude to maintain interval training velocity and O2 flux near sea-level values.

PRACTICAL TAKEAWAY - altitude training can be beneficial, but it needs to be carefully implemented and take into account the response from each individual. I'm not sure I would use the "responder" and "non-responder" terminology, but rather consider that athletes sit on a spectrum of responses and the intervention needs to take account of that.

NUTRITION: Prevalence of Surrogate Markers of Relative Energy Deficiency in Male Norwegian Olympic-Level Athletes

RED-S has become quite a well-discussed topic in the last few years and this study shows exactly why that is needed. "This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes". The results showed that

Seven athletes (16%) grouped by the presence of low resting metabolic rate (RMR), also showed lower testosterone than in normal RMR group.
In low RMR ratio individuals, prevalence of other RED-S markers (—subclinical—low testosterone, low free triiodothyronine, high cortisol, and elevated low-density lipoprotein) was (N/number of markers): 2/0, 2/1, 2/2, 1/3.
Seven of 12 athletes with two or more RED-S markers had normal RMR.

This lead the authors to conclude that:

Multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S.

PRACTICAL TAKEAWAY - be aware of your nutrition intake and make sure to eat enough. Even Olympic-level athletes are at risk of developing RED-S symtpoms which can have long-term impacts on performance.

ALTITUDE: Iron insufficiency diminishes the erythropoietic response to moderate altitude exposure

Following on in the series of altitude studies I've been reviewing, this two-part study investigated the responses to altitude exposure by athletes with differing levels of serum ferritin. The important finding of the study was that:

Thus, iron deficiency in athletes restrains erythropoiesis to altitude exposure and may preclude improvement in sea-level athletic performance.

The authors specifically called out two important points:

This study clearly demonstrates that iron deficiency in athletes inhibits accelerated erythropoiesis to a sojourn to moderate high altitude and may preclude a potential improvement in sea-level athletic performance with altitude training.
Iron replacement therapy before and during altitude exposure is important to maximize performance gains after altitude training in endurance athletes.

PRACTICAL TAKEAWAY - my understanding of altitude training is that it is beneficial, but there are a lot of factors that we have to get right otherwise the desired outcome will not be achieved. One of these key factors is ensuring adequate serum ferritin levels.

PERIODIZATION: Periodization Paradigms in the 21st Century: Evidence-Led or Tradition-Driven?

This study set out to understand periodization protocols with the view that "it can be suggested that such models share a deep-rooted cultural heritage underpinned by a common set of historically pervasive planning beliefs and assumptions". The authors point out that:

The purpose of this review is not to suggest a whole-scale rejection of periodization theories but to promote a refined awareness of their various strengths and weaknesses.
There is a logical line of reasoning suggesting an urgent need for periodization theories to be realigned with contemporary elite practice and modern scientific conceptual models.
It is recommended that increased emphasis be placed on the design and implementation of sensitive and responsive training systems that facilitate the guided emergence of customized context-specific training-planning solutions.

PRACTICAL TAKEAWAY - don't apply strict periodization models without considering how they should be adapted and designed specifically for your athletes.

PERIODIZATION: Periodization and Block Periodization in Sports

After sharing the study above, I received a great study from Tony Boutagy that explains how coaches are currently using periodization with their athletes. I appreciate the clear distinction made between periodization and programming:

Periodization deals with the micromanagement of timelines and fitness phases and is cyclic in nature. On the other hand, programming deals with the micromanagement of the training process and deals with exercise selection, volume, intensity, etc.

The authors explain that:

Evidence indicates that a periodized training process coupled with appropriate programming can produce superior athletic enhancement compared with nonperiodized process.
Both models (traditional and block periodization) have strengths and weaknesses but can be "tailored" through creative programming to produce excellent results for specific sports.

PRACTICAL TAKEAWAY - tailor your training using all the tools available (programming and periodizing) to ensure it is optimal for you.

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