Fig. 1.

Potential nutrition-related physiological/metabolic changes or nutrition interventions for various altitudes. Altitude cut-offs are as established by Bartsch and Saltin [8]. All rankings are reflective of the relative level of importance and impact, and/or evidence, compared to sea level. An equal (=) sign represents equivalent evidence and importance as at sea level. ✓✓✓✓ is convincing evidence, ✓✓✓ is strong evidence, ✓✓ is moderate evidence, and ✓ is low or emerging evidence for a physiological/metabolic change or for nutrition intervention consideration. ? indicates emerging evidence or potentially theoretical rationale, but no published studies at specific altitude or requires more scientific confirmation. BM body mass, CHO carbohydrate, EA energy availability, EEE exercise energy expenditure, EI energy intake