The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like “live high, train high” (LH-TH), “live high, train low” (LH-TL) or “intermittent hypoxic training” (IHT). Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.
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