[Performance enhancement through training at medium altitude-- from the perspective of sports medicine]

In the last 20 years, maximal oxygen uptake (VO2max) of athletes in different sport disciplines has increased, and the world records in endurance sports have improved markedly. One of the factors that has influenced the increase in endurance performance has been perceived to be altitude training. In this paper we describe the advantages and disadvantages of a "regular" altitude training (live high/train high) aiming to improve sea level performance and compare it with a new method, the so called "live high/train low" method. This method uses the advantages and avoids the side effects of altitude exposure. Several papers have shown that altitude training is able to improve VO2max but the individual response may be substantially different. In most cases it is not possible to prove statistical significance and therefore we have no data about differences between both altitude training methods. However, it is suspected that the risk of overtraining is reduced in the high/low method. Although not statistically significant it is suggested that the "high/low" method can more efficiently improve endurance performance at sea level. A monitoring of submaximal variables of exercise performance is recommended to avoid overtraining and to control the development of performance. From the current knowledge the "live high/train low" method is suggested to be the more effective altitude training method for athletes.