Hypoxic Exercise Training to Improve Exercise Capacity in Obese Individuals

Med Sci Sports Exerc. 2020 Aug;52(8):1641-1649. doi: 10.1249/MSS.0000000000002322.


Introduction: Combining exercise training with hypoxic exposure has been recently proposed as a new therapeutic strategy to improve health status of obese individuals. Whether hypoxic exercise training (HET) provides greater benefits regarding body composition and cardiometabolic parameters than normoxic exercise training (NET) remains, however, unclear. We hypothesized that HET would induce greater improvement in exercise capacity and health status than NET in overweight and obese individuals.

Methods: Twenty-three subjects were randomized into 8-wk HET (11 men and 1 woman; age, 52 ± 12 yr; body mass index, 31.2 ± 2.4 kg·m) or NET (eight men and three women; age, 56 ± 11 yr; body mass index, 31.8 ± 3.2 kg·m) programs (three sessions per week; constant-load cycling at 75% of maximal heart rate; target arterial oxygen saturation for HET 80%, FiO2 ~0.13, i.e., ~3700 m a.s.l.). Before and after the training programs, the following evaluations were performed: incremental maximal and submaximal cycling tests, measurements of pulse-wave velocity, endothelial function, fasting glucose, insulin and lipid profile, blood NO metabolites and oxidative stress, and determination of body composition by magnetic resonance imaging.

Results: Peak oxygen consumption and maximal power output increased significantly after HET only (peak oxygen consumption HET + 10% ± 11% vs NET + 1% ± 10% and maximal power output HET + 11% ± 7% vs NET + 3% ± 10%, P < 0.05). Submaximal exercise responses improved similarly after HET and NET. Except diastolic blood pressure which decreased significantly after both HET and NET, no change in vascular function, metabolic status and body composition was observed after training. Hypoxic exercise training only increased nitrite and reduced superoxide dismutase concentrations.

Conclusions: Combining exercise training and hypoxic exposure may provide some additional benefits to standard NET for obese individual health status.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Composition
  • Body Mass Index
  • Exercise Therapy / methods*
  • Exercise Tolerance*
  • Female
  • Humans
  • Hypoxia
  • Insulin / blood
  • Lipids / blood
  • Male
  • Middle Aged
  • Obesity / physiopathology
  • Obesity / therapy*
  • Oxidative Stress
  • Oxygen / blood
  • Oxygen Consumption
  • Physical Conditioning, Human / methods
  • Prospective Studies
  • Single-Blind Method
  • Superoxide Dismutase / blood


  • Blood Glucose
  • Insulin
  • Lipids
  • Superoxide Dismutase
  • Oxygen