Optimizing nutrition for performance at altitude: a literature review.

Human beings are unique for their capacity to maximize their physical potential through various means. High altitude mountaineering is one such way that people challenge generally accepted notions about what is biologically and evolutionarily possible. While a 20,000+ft summit may be uninhabitable for extended periods of time, enterprising individuals have demonstrated that even the most remote locations are accessible with sufficient physical effort and proper strategy. High altitude athletes, and the scientists who study them, generally focus their research and preparation on physiological parameters, with a particular emphasis on the cardiopulmonary system. While careful scrutiny in this area is certainly justified, the relationship between physiological output at altitude and nutrition is somewhat neglected in the literature. Many athletes, alpinists included, consider eating to be instinctive and mundane. However, very few activities at 30,000 ft or even 15,000 ft are intuitive. Furthermore, nutrition is one of the few variables mountain athletes can control in an otherwise unpredictable environment. Despite the intrinsic limitations and seemingly contradictory findings often associated with performance nutrition studies at high altitude, mountain athletes should adhere to certain dietary guidelines related to macronutrient composition, micronutrient supplementation, and hydration status.