Top 6 Nutrition and Hydration Tips for High Altitude

By Marisa Michael, MSc, RDN, LD

Updated September 16, 2022

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Nutrition Tips | Hydration | Meal Replacement Drink Recipe | High Altitude Webinar

Do you have a high-altitude trip planned soon? Maybe you live at a lower elevation but are going backpacking, skiing, or rock climbing at higher elevations. There are a few things to know to make your trip more enjoyable. Planning ahead and knowing how your body responds to altitude can make the difference between feeling amazing or not being able to finish what you started.

High Altitude Defined: 

What does “thinner air” mean?

As you go higher, the air is “thinner.” This means oxygen molecules are spread farther apart than at sea level. What does that mean for your body? For each breath of air, you inhale, less oxygen is delivered to your tissues.

Why is this a problem at high altitude?

Less oxygen can decrease performance, especially if you haven’t had time to acclimate. If you’re only there for a few days, your body won’t really have time to adapt physiologically to the higher altitude. If you’re going to be at a higher altitude for weeks, your body will begin to adapt. No matter what length of time you’re planning on staying at high altitude, it’s important to eat and hydrate right

Tip #1: Consume adequate calories while at high altitude

Weight loss is a concern when spending a lot of time at high altitudes. Now’s not the time, even if you’ve wanted to shed that extra 15 pounds. You want your body to get enough energy to fuel your adventure. If you’re losing weight on your trip, that is a sign that you need to eat more.

Possible reasons for weight loss:

• You might not have access to as much food as you need on the mountain
• Your energy expenditure (amount of energy your body uses) increases at high altitude
• You are exerting more effort because of the difficulty of the terrain or nature of your trip
• Appetite is sometimes decreased

Eating more calories can be helpful to aid your body in adapting to altitude and exercise. It can also help your immune system, which can be compromised at a higher altitude.

Tip #2: Consume carbohydrate-rich foods at high altitude 

Your body also needs more carbohydrates at high altitudes. Adrenaline, noradrenaline, and cortisol are all elevated with exercise at altitude. These hormones increase the use of carbohydrates for fuel. Carbohydrate is also your body’s preferred energy source, especially at high altitudes.

Researchers recommend at least 60% of your intake be from carbohydrates. This can be done by eating foods and drinking fluids that contain carbs.

Sources of carbohydrates:

• Bread
• Pasta
• Fruit
• Potatoes
• Milk
• Rice
• Quinoa
• Tortillas
• Gatorade or other sports drinks

Tip #3: Consume adequate protein for recovery while at high altitude

There isn’t much information about protein intake at altitude and how it may affect muscle growth. It’s probably safe to assume that you’ll need at least as much protein at a higher elevation than you would at sea level. Eating about 20-30 grams of protein after exercise and enough overall protein throughout the day is probably sufficient.

Tip #4: Don’t fear fat at high altitude

Like protein, we don’t know much about ideal fat intake at higher elevations. But high-fat foods tend to be higher in calories, which is good for eating enough overall calories to prevent weight loss.

Sources of fat:

• Jerky
• Chocolate
• Variety of nuts and nut butters
• Olive and coconut oil
• Butter or ghee

Tip #5: Load up on iron before your high altitude trip

You want to start your trip with adequate iron stores. Attempting a high-altitude adventure with low iron stores will leave you feeling fatigued. If you plan a high-altitude climb or climb at high altitude frequently, it’s worth checking your iron. Go to a physician at least six weeks before your trip and ask for some blood work to be drawn to test your iron stores. If you have any abnormalities, talk with your doctor and/or sports dietitian about supplementation and adding iron-rich foods into your diet.

Sources of iron:

• Fortified grains
• Beef
• Spinach
• Lentils
• Kidney beans
• Organ meats
• Eggs

Tip #6: Don’t forget to hydrate, hydrate, hydrate at altitude

At high elevations, it is easier to become more dehydrated (which is a bad thing) because your respiratory and urinary water losses are greater. This translates into less overall blood volume in your body. This means your heart rate may increase, but the cardiac output (the amount of blood pumped by the heart per minute) decreases.

Why is this a problem?

This means for each heartbeat, your muscles and other tissues aren’t getting the same blood and oxygen delivered to them that they are used to. Heat regulation also becomes more difficult. According to one study, there is about a 3% decrease in exercise capacity for every 300 meters above 1500 meters. Imagine trying to hike a tough route at high altitude when you’re not used to it. Perceived effort is increased. To make matters worse, usually sleep is compromised at high altitudes as well. Drinking enough can help you feel better.

How much and what types of fluid should I drink?

Fluid needs are around 3-5 liters per day (that’s about 13-21 eight-ounce cups). This is a lot, especially if you struggle drinking enough in general. Some studies have shown that drinking a beverage with carbohydrates and electrolytes (like sports drinks) is better at hydrating than water alone at altitude. You need extra fluids because of increased fluid loss through respiration and sweat from dry air. There’s some evidence that good sleep patterns and adequate hydration can help prevent symptoms of altitude sickness. Drink regularly and don’t rely on thirst, as this might not be a reliable indicator of how often you need to drink.

With a little extra attention to your food and fluid intake, your high-altitude adventure can be successful. Beat fatigue and dehydration by remembering to consume extra calories, carbohydrates, protein, and fluids.

Disclaimer: This is general nutrition advice, and you should talk with your physician before implementing any dietary or lifestyle changes.

Do you tend to lose your appetite while at high altitude?

Here’s a potential solution. Consider packing Backcountry Foodie’s fan-favorite – Chocolate Peanut Butter Shake – meal replacement drink the next time you’re hiking at high altitude.

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ABOUT THE AUTHOR:

Marisa Michael, MSc, RDN, LD is a sports dietitian and personal trainer. She has a private practice helping athletes and active people achieve better health and performance through nutrition. She is available for one-on-one consults, speaking, and writing gigs. You can book a virtual appointment online at www.realnutritionllc.com. Marisa is also the author of Nutrition for Climbers: Fuel for the Send, which can be purchased via Amazon or her website, nutritionforclimbers.com.

Sources:

• Kechikan, D. (2011). Optimizing nutrition for performance at altitude. Journal of Special Operations Medicine, 11, 12-17.
• Ladd E, Shea KM, Bagley P, Auerbach PS, Pirrotta E, Wang E, Lipman GS. (2016). Hydration status as a predictor of high-altitude mountaineering performance. Cureus, 8(12): e918.
• Ross M, Martin DT. (2015) Altitude, Cold And Heat. In Burke L and Deakin V (eds) Clinical Sports Nutrition (5th). Sydney, Australia, McGraw Hill, pp767-791