Altitude and Endurance Performance in Altitude Natives versus Lowlanders: Insights from Professional Cycling

Med Sci Sports Exerc. 2022 Jul 1;54(7):1218-1224. doi: 10.1249/MSS.0000000000002890. Epub 2022 Feb 10.


Introduction: Acute altitude exposure influences exercise performance, although most research, especially regarding altitude natives, comes from laboratory data in nonathletes.

Purpose: We analyzed the influence of altitude on real-world cycling performance in top-level professional cyclists attending to whether they were altitude natives or not.

Methods: Thirty-three male cyclists (29 ± 5 yr) were studied and were classified as lowlanders (n = 19) or altitude natives (n = 14) attending to the altitude of their place of birth (431 ± 380 and 2583 ± 334 meters above sea level (m a.s.l.), respectively). Both groups included top 3 finishers (including winners) in the general classification of Grand Tours and major races. Using data from both training and competitions during years 2013-2020 (8 ± 5 seasons per cyclist), we registered participants' mean maximal power (MMP) for efforts lasting 5 s, 30 s, 5 min, and 10 min, respectively, at altitudes ranging from 0-500 to >2000 m a.s.l.

Results: A significant altitude-MMP interaction effect (two-factor repeated-measures ANOVA) was found in lowlanders (P < 0.001) but not in altitude natives (P = 0.150). In lowlanders, individual performance decreased in a dose-response manner with increasing altitudes compared with sea (or near-sea) level (0-500 m a.s.l.), whereas this trend was much less evident in natives. A significant altitude-MMP-group effect was found (P < 0.001), with nonsignificant (and overall trivial-to-small differences) between lowlanders and altitude natives for any effort duration at altitudes ≤1500 m a.s.l. but with significant differences at higher altitudes (≥1501 m a.s.l.).

Conclusions: Acute altitude exposure influences real-world performance differently in low landers and altitude natives, which might confer a competitive advantage to the latter, particularly in races including efforts at >1500 m a.s.l.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acclimatization / physiology
  • Altitude*
  • Bicycling
  • Exercise* / physiology
  • Humans
  • Male