• It is worth spending time planning your nutrition as well as your route and equipment. To avoid a reduced energy intake through a lack of appetite you should agree to consume a set amount of food and fluid (an amount that would meet your sea level requirements) plus some extra food and fluid to cover the increase energy needs of altitude and the activity you are doing.

• Increase your carbohydrate and protein intake if the intensity of exercise has increased and better performance at high altitude is desired.

• If you have to carry all food which is mostly high in fat then try and bring powdered carbohydrate - electrolyte drink to make up and off set low blood sugar levels whilst helping hydration. Also bring some carbohydrate dense foods (see section 3 for list).

• It has been recommended that fluid requirements at high altitude may be as high as 3-5 litres per day at rest and will be increased further if with physical activity. Given that carbohydrate requirements are also increased, it is practical to gain some of your fluid from an isotonic sports drink with electrolytes.

• No evidence thus far suggests that supplementation of vitamins provides an advantage to individuals participating in prolonged treks at high altitude, provided that energy intake is adequate.

• The general consensus is that iron stores are of critical importance before prolonged exposure to altitude greater than 2500m and attention to iron in the diet before and during altitude exposure is important.

• Be aware of the symptoms of dehydration and acute mountain sickness in your group. If severe enough both can be life threatening. Do not give in to peer pressure to finish the climb.

References

The above recommendations and information were taken from the following references:

Ashenden MJ, Gore CJ, Martin DT, Dobson GP, Hahn AG (1999). Effects of a 12-day "Live High, Train Low" Camp on Reticulocyte Production and Haemoglobin Mass in Elite Female Road Cyclists. European Journal of Applied Physiology (80) 472-478

Braun B, Mawson JT, Muza SR, Dominick SB, Brooks GA, Horning MA, et al (2000). Women at altitude: Carbohydrate Utilisation during exercise at 4300m. Journal of Applied Physiology (88) 246-256.

Brooks, BA, Roberts AC, Butterfield GE, Wolfel EE & Reeves JT (1994). Acclimatisation to 4300m altitude decreases reliance on fat as a substrate and increases dependency on blood glucose. Medicine and Science in Sports and Exercise 26(5) S21

Brooks, BA, Roberts AC, Butterfield GE, Wolfel EE & Reeves JT (1994). Altitude exposure increases reliance on glucose. Medicine and Science in Sports and Exercise 26(5) S21

Butterfield GE (1999). Nutrient Requirements at High Altitude. Clinics in Sports Medicine (18) 3 607-621

Friedman B, Rating T, Weller E, Werle E, Eckardt K-U, Bärtsch P, Mairbäurl H (1999). Effects of Iron Supplementation on Total body Hemoglobin During Endurance Training at Moderate Altitude. International Journal of Sports Medicine (20) 78-85

Newsholme E, Leech T & Duester G (1997). Keep on Running. The Science of Training and Performance. Wiley; West Sussex.

Shephards RJ (1998). Immune changes induced by exercise in an adverse environment. Canadian Journal of Physiology and Pharmacology (76) 539-546.

Stroud MA (1998). The Nutritional Demands of Very Prolonged Exercise in Man. Proceedings of the Nutritional Society (57) 55-61.

Stroud, MA (1987). Nutrition and Energy Balance on the Footsteps of Scott expedition 1984-1986 Applied Nutrition (41A) 426-433

Zaccaria M, Rocca S, Noventa D, Varnier M & Opocher G (1998). Sodium Regulating Hormones at High Altitude: Basal and post exercise levels. Journal of clinical Endocrinology and Metabolism (83, No.2) 570- 574.

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