The physical and mental health benefits of walking in the mountains have long been known. Now, a recent study carried out by Dr Thomas Küpper from the Aachen University Clinic has given important insights into the effect of altitude on the human body. We sat down with Dr Küpper to talk red blood cells, euphoria and why men in their mid-40s love looking at alpine flowers.
Dr Küpper, you come from the flat region of Rheinland in Germany. What made you interested in the high mountains?
For 20 years my family spent their holidays each year on a mountain farm in Nonn near Bad Reichenhall. During my time at university in Düsseldorf I joined a rock-climbing club. Back then I was sure they would all be much better than me, but surprisingly I was actually one of the best climbers in the group. I became a climbing coach and was asked to create a first-aid course for the club. It was this which inspired my first book, “Survival alpin”.
Professor Dr Thomas Küpper, 59, is an expert specialising in the fields of mountain, sport, air, rescue and travel medicine. He has written numerous books on these topics. Küpper has climbed in the mountains for 47 years. His favourite adventures combine hiking and climbing. He also enjoys challenging climbing routes in the Alps and Himalayas.
You clearly feel at home in the mountains. Do you still go rock climbing? Is spending time in the mountains a recipe for staying fit and healthy?
Probably not if you talk to the farmers who work the steep meadows and pastures! For the rest of us, hiking and rock climbing are good for our physical and mental health. There are a number of studies which show the benefits of altitude on blood pressure and blood sugar levels. Spending time in thin air is also good for your heart and cardiovascular system. Why? On the one hand it is the physical exercise itself, on the other hand the thin and cold air makes the body work a little harder. Each breath we transports less oxygen into the lungs than at sea level. The higher up we go, the harder breathing becomes.
Why are low oxygen levels in the air good for us?
When it comes to cells in the human body, lack of oxygen is what is known as a “global event” – that means it affects the digestion, breathing and energy supply. At altitudes of between 1,500 and 3,500 metres, which includes most mountain regions in Europe, we only experience the positive effects – and these effects are significant. One of the magic words in this context is erythropoesis.
Sounds complicated. What does it mean?
All it means is that the low air pressure at altitude transports less oxygen into the lungs. The body reacts to this by creating more red blood cells – a process known as erythropoesis. That means the body is able to absorb more oxygen, which in turn has benefits for all the organs and improves overall physical fitness.
A bit like blood doping …
At a biological level the process is very similar to blood doping. However, at altitude the body needs a whole week to create new red blood cells – that’s different from blood doping, where athletes use blood bag infusions before a race.
How much time do I have to spend at altitude to feel the benefits?
Spending time at altitude always has a positive effect, no matter how long or short your stay is. To make the most of it you should head into the high mountains two or three times a year for at least ten days at a time. The more time you spend at altitude, the more your body gets used to the conditions and adapts. It’s all about acclimatisation. Just look at communities high in the mountains. In 2009 I was a spectator at the Everest Marathon, where the start line was at 5,365 metres above sea level. All the top places went to Nepalese runners. I can’t imagine how annoying it must have been for an Olympic finalist from the USA to be passed by a Sherpa woman wearing a dress and flip-flops!
Many people who go to the Himalayas suffer from altitude sickness. Does that also happen to tourists in the Tirolean Alps?
Basically, the higher up you go the more important it is that you give your body time to acclimatise. If you rush things you can, in the worst case, end up with a lung clot or brain clot. However, in Tirol you have nothing to worry about. The Eastern Alps are not high enough to develop such dramatic symptoms. Above 2,500 metres you may feel some mild effects such as headache, dizziness, nausea, etc. A fellow specialist in altitude medicine, Jim Milledge, once put it like this: “You might feel like crap, but you’re not going to die.”
Is everyone at risk of developing altitude sickness?
It is very individual – if two people climb the 3,000-metre Guslarspitzen mountain together, one might feel just fine and the other might get a headache.
And what can you do to avoid “feeling like crap”?
Visitors to the mountains should take things slow and steady. Give your body time to acclimatise. Altitude sickness isn’t just a question of how high you hike during the day. If the weather is good then you can climb Austria’s highest mountain, the Großglockner, without too many worries. But you should not spend the night up on the summit. That’s a really important factor: the altitude at which you sleep. When you get to altitudes above 2,000-2,500 metres, you should make sure you don’t move up more than 500 metres per night.
Any other tips?
I remember going to the Grand Canyon and reading a sign on the mountain telling hikers to drink four gallons or 16 litres! That’s rubbish. The human body uses liquid much more effectively and loses liquid much more slowly than we used to think a few years ago. If you drink too much salt-free water then you will dilute the salts in your body and develop a lack of sodium. In the end, you will collapse. That’s why it is much better to drink regularly and sensibly. That is the best way of staying fit and feeling good at altitudes of around 2,000-3,000 metres.
What about if I have a health condition? Can I still go to the mountains?
Doctors can sometimes create unnecessary panic and advise people with, for example, heart conditions against spending time in the mountains. There is no need to be worried. People with even serious heart, lung and other conditions can come to the mountains, but they should talk to a doctor beforehand and keep an eye on their condition during their stay. Nobody has ever died of a heart attack simply by being in the mountains.
Doctors often recommend that asthma sufferers and heavy smokers should spend time in the mountains.
Yes, that’s true. Mountain air contains fewer toxins such as fine particles and allergens. Another advantage is that thin air can pass smoothly through the narrow, inflamed pathways in the lungs. If, however, the lungs are severely damaged and unable to expand, people should stay at lower altitudes. That is really important.
People who suffer from dust allergies and hay fever also seem to have fewer symptoms at altitude.
Allergy sufferers benefit from the clean air with low concentrations of fine particles and pollen. Up in the mountains the blossoming period of flowers is shorter. The vegetation is different than at sea level – and there is generally less vegetation than further down in the valley. For allergy sufferers this means zero or minimal pollen.
Why do we sleep better in the mountains?
Because we are tired and not used to the physical exercise. However, the higher you go the more difficult it actually becomes to sleep. Shallow breathing at altitude messes with our natural sleeping rhythm. Every now and then we skip a breath. This means we never really get into the deep sleep our body needs to recover. It’s more like taking a quick nap than getting a good night’s sleep. And if you’ve got somebody snoring away next to you then that certainly doesn’t make things any easier!
And yet people still love going into the mountains to hike and climb.
Yes. Everything seems to be better in the mountains. On a psychological level, the mountains have an immediate effect on us. It feels good to escape daily life and enjoy the mountain landscape. It is for this reason that many people come to the mountains to recover after an illness or operation. The physical effects of the therapy are the same at sea level, but the psychological effect of being in the mountains is also very beneficial. We shouldn’t underestimate this sense of euphoria – that feeling of “Wow, it’s so beautiful!” That is something we take back home with us at the end of our stay.
Is there any way to hold onto those benefits once you get back into the daily routine?
If you go into the mountains fit and healthy, you will feel the positive effects for a while even when you get back home. However, I recommend building up your stamina before your holiday if you want to make the most of your time in the mountains. In my work as a doctor and sports science specialist I have seen again and again unfit men in their mid-40s who head into the Alps with their pretty young girlfriends and are keen to impress them with their physical prowess. Those midlife crisis guys are the kind of people who would never admit to being exhausted – but you will notice how they stop every few metres to look at a flower by the trail or take a photo of the view. Keep your eyes open next time you are in the mountains and you will see them!
Is is true that spending time in the mountains helps you lose weight?
Several studies have shown that at high altitudes the human body does not burn carbohydrates but instead burns fat. That is particularly the case in mountainous regions at 2,000-3,000 metres such as most areas of the Eastern Alps.
Is there any time of year which is particularly good for high-altitude adventures?
The human body performs better in summer. All major world records have been set in summer. But more important than that is the question: when is the most enjoyable time of year for you? Do you want to go skiing, look for minerals or break records?
How often can you be found in the mountains yourself?
As a passionate hiker I guess I should say “as often as possible”. However, I have to admit that last year I only made it to the mountains once – in Nepal for a training seminar with 90 doctors. We did lots of learning, but we also found time for a bit of team building roped together!