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Resting and Physical Activity Energy Expenditure Across an Altitudinal Gradient: An Adjusted Analysis
Margot Evelin Bernedo-Itusaca1,2, Shantal Cutipa-Tinta1,2, Judith Marie Merma-Valero3
1Facultad de Medicina Humana, Universidad Nacional del Altiplano, Puno 21000, Peru.
Oxygen (Basel, Switzerland)
|July 28, 2026
Summary
High altitude survival requires energy management, but altitude itself doesn't independently affect caloric costs. Body mass index and physiological factors like oxygen saturation significantly influence energy expenditure in Andean residents.
Area of Science:
- Physiology
- Human Adaptation
- Environmental Medicine
Background:
- High-altitude survival necessitates efficient energy management.
- The independent effects of altitude and demographics on caloric costs remain unclear.
Purpose of the Study:
- To evaluate the independent impact of altitude versus demographic factors on basal and exertional caloric costs in chronic high-altitude residents.
Main Methods:
- Cross-sectional study of 141 healthy adults across four Peruvian altitudes (154m to 5100m).
- Measured resting energy expenditure (REE) and physical activity energy expenditure (PAEE) using photoplethysmography and 6-min walk test (6MWT).
- Analyzed hemodynamic parameters, SpO2, Hb, and used ANCOVA to adjust for age, sex, and BMI.
Main Results:
- Unadjusted data showed increased REE and PAEE with altitude.
- ANCOVA revealed no significant independent effect of altitude on energy expenditure after adjusting for covariates like BMI.
- Lower SpO2 significantly increased REE; high Hb levels (>18 g/dL) exponentially increased caloric cost due to hyperviscosity.
Conclusions:
- No independent relationship exists between resting energy expenditure and altitude of residence.
- Covariates, especially BMI, negated the initial altitude-energy expenditure relationship.
- Functional capacity is maintained at the cost of energy economy, highlighting the physiological burden of Andean acclimatization.
