Heat acclimation with or without normobaric hypoxia exposure leads to similar improvements in endurance performance in the heat

Background: Combining the key adaptation of plasma volume (PV) expansion with syner-gistic physiological effects of other acclimation interventions to maximise endurance performance in the heat has potential. The current study investigated the effects of heat acclimation alone (H), combined with normobaric hypoxia exposure (H+NH), on endurance athletic performance. Methods: Well-trained participants completed a heat-stress trial (30 °C, 80% relative humidity (RH), 20.8% fraction of inspired oxygen (FiO2)) of a 75 min steady-state cycling (fixed workload) and a subse-quent 15 min cycling time trial for distance before and after intervention. Participants completed 12 consecutive indoor training days with either heat acclimation (H; 60 min·day−1, 30 °C, 80% RH; 20.8% FiO2) or heat acclimation and overnight hypoxic environment (H+NH; ~12 h, 60% RH; 16% FiO2 simulating altitude of ~2500 m). Control (CON) group trained outdoors with average maximum daily temperature of 16.5 °C and 60% RH. Results: Both H and H+NH significantly improved time trial cycling distance by ~5.5% compared to CON, with no difference between environmental expo-sures. PV increased (+3.8%) and decreased (−4.1%) following H and H+NH, respectively, whereas haemoglobin concentration decreased (−2%) and increased (+3%) in H and H+NH, respectively. Conclusion: Our results show that despite contrasting physiological adaptations to different environmental acclimation protocols, heat acclimation with or without hypoxic exposure demonstrated similar improvements in short-duration exercise performance in a hot environment