By Rob Shaul
Based on Karpęcka-Gałka, E., & Frączek, B. (2024). Nutrition, hydration and supplementation considerations for mountaineers in high-altitude conditions: A narrative review. Frontiers in Sports and Active Living, 6, 1435494. https://doi.org/10.3389/fspor.2024.1435494
BLUF:
Mountaineering at high altitudes (>2,500 m) presents unique physiological challenges due to hypoxia, cold exposure, and increased energy demands. A systematic review of literature found that maintaining energy balance, proper hydration, and strategic supplementation are critical for optimizing performance and mitigating risks such as altitude sickness, cognitive decline, and excessive weight loss. Climbers and others working at these altitudes can burn 4,500-8,000 kcal/day – which is difficult to sustain given appetite loss and other factors, including protein deficiency.
Purpose of the Study
1. Examine the impact of high-altitude conditions on nutritional requirements.
2. Provide evidence-based recommendations for energy intake, macronutrient distribution, and supplementation.
3. Discuss hydration strategies and electrolyte balance to maintain physiological function.
Subjects
- Population Studied: Review included studies on mountaineers, high-altitude trekkers, and military personnel operating above 2,500 m.
- Study Types: Randomized controlled trials, narrative reviews, systematic reviews, and meta-analyses from 2000 to 2023.
Research Method
Databases searched included PubMed, Scopus, ScienceDirect, and Google Scholar. Inclusion criteria focused on studies analyzing nutritional needs, hydration, and supplementation effects in high-altitude environments. Exclusion criteria removed studies on permanent high-altitude residents and non-relevant populations.
Findings
Energy Balance and Macronutrients:
- Energy Expenditure: Climbers at 5,000–8,000 m require 4,500–6,000 kcal/day. However, actual intake often falls short due to appetite suppression.
- Carbohydrates: Essential for high-altitude exertion; recommended intake ranges from 6–10 g/kg body weight/day.
- Protein: Minimum 1.4 g/kg/day to mitigate muscle loss. High-altitude catabolism leads to up to 60% of weight loss from lean body mass.
- Fats: Should contribute 20–35% of total energy, focusing on unsaturated sources like nuts and oils.
- Fluid loss at altitude is increased due to hyperventilation and dry air, requiring 4–5 L/day intake.
- Electrolyte supplementation is recommended, particularly sodium (0.5–1 g/L) to maintain hydration and prevent hyponatremia.
Supplementation Strategies:
- Iron: Needed to support erythropoiesis; deficiencies impair acclimatization. Supplementation recommended if ferritin <40 ng/mL.
- Omega-3 Fatty Acids: Potential benefits for reducing inflammation and muscle degradation.
- Probiotics: May support gut health and immune function, counteracting hypoxia-induced gastrointestinal issues.
- Antioxidants (Vitamin C, E, Selenium): May mitigate oxidative stress but should be used cautiously as excessive doses may impair adaptation.
- Caffeine: Enhances cognitive function and alertness but should be used in moderation.
- Beetroot Juice (Nitrates): Evidence suggests potential benefits for endothelial function, though its role in altitude performance is inconclusive.
Limitations:
- Short Study Durations: Limited longitudinal data on long-term effects of high-altitude nutrition.
- Population Bias: Predominantly male subjects; female-specific needs are understudied.
- Variability in Study Conditions: Differences in study methodologies and environmental factors make direct comparisons challenging.
Training and Policy Implicatons:
Nutritional Strategies:
- Pre-expedition carbohydrate loading and iron status assessment.
- Prioritization of digestible, energy-dense foods during climbs.
- Monitoring hydration through urine color and adjusting electrolyte intake.
Supplementation Guidelines:
- Individualized iron and vitamin D supplementation based on pre-expedition blood test
- Consideration of probiotics and omega-3s to support immune and metabolic function.
- Use of caffeine and antioxidants for performance and recovery, with caution regarding potential adaptation interference.
Occupational Applications:
- Military Personnel: Nutrition plans should account for prolonged exertion in hypoxic environments.
- Wildland Firefighters: Similar energy and hydration challenges due to high workloads and altitude exposure.
- Tactical Athletes: Endurance-focused carbohydrate fueling strategies can enhance operational readiness.
- High-Altitude Workers: Consideration of iron and electrolyte intake to prevent fatigue and cognitive decline.
Conclusions:
Proper nutrition, hydration, and supplementation strategies are critical for maintaining health and performance in high-altitude conditions. A focus on carbohydrate intake, hydration management, and targeted supplementation can mitigate the physiological challenges of hypoxia, cold exposure, and increased energy expenditure. Future research should explore long-term adaptation mechanisms and gender-specific nutritional needs in high-altitude environments.
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Source:
Karpęcka-Gałka, E., & Frączek, B. (2024). *Nutrition, hydration and supplementation considerations for mountaineers in high-altitude conditions: A narrative review.* Frontiers in Sports and Active Living, 6, 1435494. https://doi.org/10.3389/fspor.2024.1435494