The 1:59 Marathon
PART 6
Live High Race Low

Dr. Phil Maffetone

In addition to the many facets of endurance training, the ability to prepare and execute a 1:59 marathon will require numerous other considerations. An important one may include where the runner was born, and where he or she lives, trains, and races. This can impact the quality and quantity of red blood cells and oxygenation, more effectively rid the body of carbon dioxide (which is as important as getting oxygen in) and even affect the size of ones lungs. All this can reduce seconds with each race mile, helping an athlete run a 1:59 marathon.

Most of today’s top marathoners were born or lived a considerable amount of time at higher altitudes. This helps the body develop rich red blood and larger lung capacity to get more oxygen out of the air, and eliminate carbon dioxide. Because these changes also help muscles function better, the result can be significantly improved performance. The “live high train low” training approach could improve ones marathon times by up to four percent, which by itself is enough of an improvement for a number of world class athletes today to run a 1:59 marathon.

But it’s not training in this environment that provides the benefits, it’s living there for several weeks or more. Returning to a sea level event, for example, three weeks before race day is the ideal situation. When descending to a lower altitude your oxygen uptake immediately improves, as does performance.

While lower altitude would also make the best locale for training and recovery, and for the race itself, the best environment for living, all those downtime hours, including sleeping, is higher altitude. This can significantly help improve the body’s ability to take in and utilize oxygen. This “live high, train low” idea is nothing new. Properly done, and in a healthy athlete, it can take minutes off ones marathon time.

In addition to improved changes in blood chemistry, other potentially healthy changes may occur in aerobic muscles while living and training long enough at altitude. These include increased circulation in aerobic muscles, increases in myoglobin (the red pigment in aerobic fibers) and aerobic enzymes to help with fat burning, and improvements in lactate metabolism.

There are two ways to accomplish “live high train low.” One is to find a location that has both high and low elevations in close proximity. One would live at the higher altitude, the mountaintop, such as those between five and seven thousand feet. Each day, the runner would “commune” down the mountain to lower elevations, the lower the better, for all training.

The second option is to use both mild hyperbaric and hypobaric chambers to mimic low and high altitudes, respectively. In this case, the runner would use the hyperbaric chamber following each training session for an hour or more. One need not add oxygen to the chamber, just ambient air. This will help raise oxygen uptake and speed recovery. At night, sleeping in a hypobaric chamber can accomplish what living at high altitudes can do—increase the body’s production of the hormone EPO (erythropoietin), which stimulates the production of more red blood cells to carry additional oxygen.

All these potential changes and responses by the body are also individual. Some respond better to altitude while other have a difficult time. The overall levels of health may be the most important factors, with a variety of specific dietary, nutritional, and stress factors being necessary to obtain benefits at altitude. For example, if your ability to make red blood cells is impaired due to low folic acid or iron levels, being at altitude won’t help. This does not mean you should take an iron supplement if you’re going to train at altitude. Consuming a healthy diet, sufficient in iron, will provide your body with the amount of iron needed to make appropriate levels of red cells. And when going to altitude, the body automatically adjusts by absorbing three to four time more iron from your diet (like with most nutrients, the brain and body know just how much you need to take from your food as it passes through the intestines). Taking iron supplements when you’re not anemic can be dangerous as it can cause significant chemical stress and even physical stress on the intestines.

The particular altitude effects vary with the ascent, with higher altitudes producing better results. It’s difficult to say what that magic altitude is because of individual variation and positive and negative effects of various altitudes. For example, red blood cell responses may be better at an 8,000-foot altitude compared to 5,000 feet, but other stresses exist at the higher levels, such as the increased risk of dehydration and even lower oxygen uptake slowing your training pace. Altitudes between 4,000 and 7,000 feet may be the best general range for potential improvement in fitness and health, if you’re already fit and healthy, you train with a heart monitor adhering to the maximum aerobic heart rate based on the 180 formula, and you carefully assess your progress and avoid flirting with overtraining.

The use of a portable mild hyperbaric chamber is easy to use. While these devices simulate low altitude and high barometric pressure (and higher oxygen uptake), even without the addition of oxygen, another type of device does the opposite. Hypobaric chambers simulate higher altitude and low pressure. The hypobaric chamber offers individuals exposure to a high-altitude environment while at rest—napping, reading, and relaxing, or sleeping through the night—with normal training taking place at the level of altitude where they live. This provides the convenience of “living high and training low.” In most cases, athletes sleep in the hypobaric chambers, and each night they obtain a variety of high-altitude benefits.

Hypobaric chambers are not as portable as the small inflatable mild hyperbaric chambers. But my long-term use of these high-altitude simulators, both personally and with athletes, has also been very positive. The most dramatic benefit of hypobaric exposure is the increase in your body’s natural production of EPO (erythropoietin), which begins almost immediately with hypobaric exposure. EPO stimulates the production of more red blood cells, which increase the body’s oxygen-carrying capacity, or ability to get oxygen to working muscles, by as much as 150 percent. In addition, more blood vessels are developed, especially in the aerobic muscles. It’s obviously more healthy and natural to increase your EPO this way than to inject synthetic EPO (which is illegal for most people and dangerous) or use other blood-doping methods (also illegal and dangerous). The result is improved oxygen carrying capacity and dramatic performance enhancements—all obtained legally and healthily.

To assure the benefits of “live high train low” are being obtained, blood testing is important. This may include:
• A complete blood count (CBC) to monitor red-cell count, hemoglobin, and hematocrit gives a more complete picture of physiological benefits.

• Testing levels of iron, ferritin, folic acid, vitamin B12, and other nutrients provides information to ensure athletes have the raw materials to obtain optimal benefits from hypobaric exposure.

• The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are important tests to help rule out chronic inflammation.

Both diet and nutrition can have a significant influence on the effectiveness of hypo- and hyperbaric therapy. Because chronic inflammation can inhibit EPO production, when using an altitude chamber it’s important to consider the powerful dietary aspects that regulate inflammation, including balancing dietary fats, and making sure you get certain vitamins and minerals and adequate protein. It is also important to assess your iron, B12, and folic acid status, and your antioxidant intake as well when using any device that increases EPO.

Some nutrients have obvious potential impact on the athlete’s physiology, and this becomes even more acute with hypobaric exposure. A variety of specific nutritional factors may further help athletes who use hypobaric chambers to improve health and performance. Below is a list of some:
• Iron deficiency could decrease oxygen-carrying capability.

• Inadequate protein intake could negatively influence EPO production.

• There may be an increased need for antioxidant nutrients.

• Folic acid status could have a significant effect on the production of EPO and red blood cells.

• Omega-3 fatty acids from fish oil may impact the quality of red blood cells produced, and help reduce inflammation.

While anyone can “live high train low,” and reap the fitness and health benefits, applying these concepts to train for a 1:59 marathon may be another tool that helps lead to success.
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