Improved Race Performance in Elite Middle-Distance Runners After Cumulative Altitude Exposure

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 (VO(2max) 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.