Medication Training Nutrition

Food preparations – on to the Khan Tengri

In mid-August Boris and Jur leave for their general rehearsal expedition on the Khan Tengri. The Khan Tengri is a mountain top on the border of Kazakhstan and Kyrgyzstan and on the Ğeňiš Čokusu after the highest peak of the Tiensan mountains. Khan Tengri has an altitude of 7010 meters and is therefore a serious expedition in which both will face fatigue challenges, altitude sickness, extreme weather conditions and many technical passages. In short, a good try-out for next year. To use this expedition as much as possible and to test and train the latest skills, we pay a lot of attention to making an exercise plan. In this blog I will take you along in a plan of nutritional supplements that I want to use on them.

In previous blogs you could read how we experimented with different foods below the altitude sickness threshold and the corresponding way to use them correctly.
We have been able to draw up a number of do’s & don’ts from this experimental phase that we can take with us to next year. Some examples of this are, a selection of the favorite and most useful snacks for during the climbing days, the practice of taking in liquids and nutrients at the right moments so that they have the best effect on performance, taking a closer look at the practical opportunities to take / prepare food & drink and to learn to listen and act to the signals that the body emits in response to certain foods. We will process all this data in the larger experiment of the Khan Tengri. In addition, we implement the more advanced assignments, including eating and drinking at a high altitude, preparing and taking in food /medication / supplementation to a high altitude, and monitoring the effects of these assignments.

Medication to support the expedition

For this project we work together with Irene Schrijvershof, expedition arts. She will advise medication to both men during the Khan Tengri expedition.

(In addition to this medication, we are also experimenting with dietary supplements. It is important to keep an eye on whether the medication can conflict with the medication that may be taken.)

A decrease in glycogen stores in the muscles, an increased protein breakdown, a disturbed fluid and electrolyte balance and altitude sickness are the most common causes of poorer performance at altitude. The sizes in which altitude sickness occurs are variable, but it affects many climbers: on altitudes between 4000 and 5800 meters, on average 67% of people suffer from it, with a variation of 25 to 100%. In the worst case, it leads to cerebral edema and even death.

In some cases medicines are also administered to prevent altitude sickness, but these medicines can also be harmful, in particular because Boris and Jur go for 7 expeditions in 1 year, the use of medication on a recurring basis is not recommended and we will try to absorb this as much as possible with nutrition and nutritional supplements. There are a number of things to take into account:

Risk of malnutrition

Staying at height leads to a greatly increased energy requirement due to extreme cold, physical activity and lack of oxygen (hypoxia). The requirement is estimated at 4500 to 6000 kcal per day. However, at high altitudes the appetite decreases and the experience of flavors is partially suppressed. The result is a loss of body weight, especially above 4000 meters. If mountain climbers do not consume more than 2250 kcal per day, a three-week expedition can result in a weight loss of around 10 kg! The necessary measures that we take for this is to closely monitor the intake of the number of calories. For this they already practice taking a large breakfast of at least 600 – 1000 kcal.
A number of nutritional solutions for this could be:
– Coconut oil, butter and oil intake
– Intake of nuts, seeds, seeds, avocado, oatmeal, and dried fruits
– Intake of energy drinks, fruit juices, energy bars etc.
– At a height, intake of less healthy but very tasty products may be the only solution to get the number of calories per year with a limited appetite. Think cold pizza, chocolate, pudding, candy and cake.

Risk of protein deficiency

During difficult climbs, such as a mountain of 8000 meters with an average stay of four weeks, protein deficiency easily arises. This makes mountain climbers more sensitive to edema (accumulation of extra cellular fluid in tissue, leading to swelling without increasing the number of cells.) For example in the face and hands. Risks are especially the aforementioned cerebral (brain) edema and pulmonary (lung) edema. That is why adequate protein intake is important. For endurance athletes, an intake of 1.2 to 1.4 grams of protein per kg of body weight is recommended. In strength sports this is 1.7 grams. At high altitudes, however, it may be wiser to take more carbohydrates to prevent the risk of glucose deficiency. (Long-lasting glucose deficiency drives the body to break down protein.) In this sense, whey protein can be ideal because it is rapidly absorbed and the increased protein breakdown that occurs during high-altitude activity stops as quickly as possible. Here we choose the amino acid preparations BCAAs combined with B6, L-Glutamine and the Whey preparation Whey Isolate.

Fatty acids, vitamins and iron

We also look at the importance of good fats, because they are of great importance for the health and nutritional status. We want to make saturated and polyunsaturated fatty acids no more than a maximum of 35% of the total calorie intake. Polyunsaturated fatty acids, except for omega-3, are prone to lipid peroxidation which can lead to increased oxidative stress in the body, especially during mountaineering. The advice is therefore to use monounsaturated fatty acids, mainly in the form of olive oil and nuts such as almonds. In the event of injury, fish oil capsules can cause bleeding. So that is something to keep an eye on. As long as this is not the case, we will practice the intake of 1-2 capsules of fish oil per day, partly due to their immune-modulating effects that may be useful for climbers. We also want to give special attention to fat-soluble vitamins in the high mountains, especially vitamin E. This is also due to the lack of energy intake and the moderate consumption of fatty foods at high altitudes. To nip this problem in the bud, it is advisable to charge the body with fat-soluble vitamins before leaving for the mountains. We recommend taking 200 to 400 IU of vitamin E daily for three to four weeks before departure, so we are already starting to do so. Fat-soluble vitamins are stored in fat tissue, so that ‘homework’ can be done in advance. This story does not apply to water-soluble vitamins, such as vitamin C. This vitamin must therefore be taken daily in the mountains, also to promote the absorption of non-haem iron.

The longer the stay, the greater the chance of iron deficiency

The mineral iron is also a point of attention: iron plays an important role in the transport of oxygen, in the blood and in the muscles. The longer the stay in the high mountains, the greater the chance of iron deficiency. After three weeks at a height, iron is extracted, almost nobody escapes. That is why we want to go on an expedition with high iron reserves and follow specific nutritional strategies and / or therapy with iron supplementation for stays longer than two weeks. We will come back to this later when we take a closer look at blood values.

More supplementation for altitude sickness

There are a few other interesting nutritional supplements that relate to altitude sickness, for example Ginko Biloba. Studies show different results, but there are substantial indications that Ginko Biloba would improve blood flow and therefore oxygen transport at high altitudes, causing altitude sickness to stay away longer, we want to start 3 weeks before departure. And continue to measure up to 10 days after the expedition.

Loss of magnesium

The last one I want to discuss in this blog is Magnesium. Magnesium can reduce the risk of dehydration and keep muscle tone low so that relaxation for a good night’s rest and recovery for the next day can be improved.

Do it yourself!

Good preparation is half the job. Make sure you know how you are doing when you embark on a tough expedition. It is wise to have your blood values measured for deficiencies. Supplementing the above foods is a good idea. If you would like advice about your personal situation, feel free to ask your questions in the comments below or send me an email with your schedule to; [email protected]

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