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Updated: Jul 3, 2026

A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement
Published on: February 22, 2022
Live high, train low at natural altitude.
J Stray-Gundersen1, B D Levine
1The Cooper Clinic, 7850 Colin-McKinney Pkwy, McKinney, TX 75070, USA. jstray-gundersen@cooper-clinic.com
Altitude training (living at 2500m, training near sea level) can improve sea-level endurance performance by 1.5% for 3 weeks. This is linked to increased red cell mass and maximal oxygen uptake.
Area of Science:
- Sports Science
- Exercise Physiology
- Altitude Training
Background:
- Altitude training is a common practice for endurance athletes seeking to improve sea-level performance.
- The efficacy and underlying mechanisms of altitude training have been extensively investigated.
Purpose of the Study:
- To evaluate the impact of a "live high, train low" altitude training strategy on sea-level endurance performance.
- To identify the physiological mechanisms responsible for any observed performance enhancements.
Main Methods:
- Athletes lived at 2500m for 4 weeks, performing intense training sessions near sea level.
- Performance metrics, red cell mass, maximal oxygen uptake, running economy, and anaerobic markers were assessed.
Main Results:
- An average improvement of 1.5% in sea-level endurance performance (7-20 min duration) was observed, lasting at least 3 weeks post-training.
- A significant increase in red cell mass (approx. 8%) and maximal oxygen uptake (approx. 5%) was noted.
- No significant changes were found in running economy or anaerobic energy utilization markers.
Conclusions:
- The "live high, train low" altitude training approach effectively enhances sea-level endurance performance in collegiate to elite athletes.
- Increased red cell mass and improved maximal oxygen uptake are key mechanisms driving performance gains.
- While direct studies in football are lacking, enhanced maximal oxygen uptake could benefit football performance, though the 4-week time commitment is a consideration.
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