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Triathlon For a Healthy Brain – Pat & Joan Hogan’s Story

Triathlon For a Healthy Brain – Pat & Joan Hogan’s Story

The physical exercise that accompanies endurance sports like triathlon supports a healthy brain. Just as our muscles adapt to the stress of weight training to become stronger, our brain adapts to new challenges.

Most of us are familiar with some benefits of what Dr. Patrick Hogan calls “challenging exercise”. For example, we know that exercise promotes cardiovascular health.

However, did you know that there is a 45% decrease in incidence of Alzheimer’s dementia in those who do an adequate duration and intensity of exercise consistently into older age? Neither did I until I spoke with Dr. Pat and Joan Hogan.

Add to this the psychological benefits of social interaction and improved thoughts of gratitude, confidence, and hope that accompany triathlon training and who shouldn’t want to get involved.

Improved brain function is an important reason Pat and Joan Hogan have continued in triathlon into their 70s. It is also why they plan to continue to train and compete in the sport as long as possible.

Who Are Pat and Joan Hogan?

I recently had the pleasure of meeting Pat and Joan, first through email and later over the phone, as they sought to connect with Craig Cross, another senior triathlete whose story appears here.

Dr. Patrick (Pat), DO, and Joan Hogan, RD, are part of the Puget Sound Neurology and Integrative Headache Center in Tacoma, Washington. Their practice is focused on treating movement disorders, migraines, and pain from other sources.

Dr. Hogan, Director of the Center, has spent much of his career treating neurological disorders such as Parkinsons and Dystonias. In fact, the National Parkinson’s Foundation has granted his Parkinson’s treatment program national recognition as a Center of Excellence. 

Joan has been a Registered Dietician for over 30 years. Her specialty within the practice is testing and therapy for delayed food and food additive hypersensitivity. For many individuals, food sensitivity is a source of pain, disease, and discomfort.

Joan has also written a book titled “Nutrition for the Ailing Brain: Your Guide for Parkinson’s Disease and Other Neurological Disorders“.

Both Pat and Joan are active triathletes, having completed various distance triathlons, including half and full Ironman races.

Over 70 Years Combined Competing in Triathlon

The Hogans put into practice in their own lives what they prescribe for their patients – challenging exercise, a healthy diet, and quality sleep. Pat and Joan have a combined experience in endurance training, particularly triathlon, of over 70 years.

Pat completed his first triathlon in 1984 while serving in the Army as a neurologist at Tripler Hospital in Honolulu, Hawaii. After completing the Honolulu Marathon, a friend introduced him to triathlon.

Since he enjoyed swimming, biking, and running, Pat chose as his first triathlon an Olympic distance race in Hawaii. He has never looked back.

Joan’s experience is almost as long as Pat’s. She completed her first triathlon, an indoor race, in 1987. Like Pat, she combined her love for swimming, biking, and running as individual sports to take the leap to doing a triathlon.

While she was comfortable in a pool, swimming in the open water, especially in cold water, was another thing. After completing one triathlon involving an open water swim in cold water without a wetsuit, she hit pause on the sport for a while.

However, once Pat and Joan began training together, Pat convinced her to get a wetsuit. This addressed the cold water part of the challenge.

Demonstrating one benefit of training with a partner, Pat also helped Joan “slay the dragon” of her anxiety with the open water.

They completed their first triathlon together about 20 years ago in Ft. Louis, Washington.

Pat and Joan Hogan's 'wall of pain'. They train for and compete in triathlons to support a healthy brain and a healthy heart.
With over 70 combined years in the sport of triathlon, Pat and Joan Hogan have collected many awards and medals.

What is the Relationship Between Exercise and Brain Health?

Much of the benefit of triathlon training, such as improved endurance, improved coordination, and improved speed, occurs through changes in the brain that are then transmitted to the muscles.

According to Pat, a program of challenging physical exercise, such as triathlon training, activates the chemical irisin that is released into the brain. Irisin stimulates Brain Derived Neurotrophic Factor (BDNF) which leads to formation of new brain cells. It also produces new connections within the brain. While BDNF naturally decreases with age and stress, it increases with exercise.

These new brain cells and synaptic connections improve brain function and prevent diseases, such as Alzheimer’s and Parkinson’s.   

Thankfully, the areas of the brain most prone to atrophy, the hippocampus and frontal cortex, are the parts most improved by exercise since exercise-produced BDNF is most concentrated in these areas of the brain.

In humans, robust effects of exercise have been most clearly demonstrated in aging populations, where sustained exercise participation enhances learning and memory, improves executive function, counteracts age-related and disease-related mental decline, and protects against age-related atrophy in brain areas crucial for higher cognitive processes.

Carl W. Cotman, Nicole C. Berchtold and Lori-Ann Christie, Exercise Builds Brain Health: Key Roles of Growth Factor Cascades and Inflammation, Trends in Neurosciences, 30(9):464-72, October 2007.

The Hogan’s Approach to Triathlon Training

The Hogan’s take a holistic view of their triathlon training. Undoubtedly, this comes from melding their professions with the sport.

Their training includes, of course, the physical components related to endurance swimming, biking, and running and to strength training. However, equally important in their training are nutrition and rest.

While many consider nutrition and rest as ‘nice to have’ but not necessarily that important for the overall preparation for a triathlon, these two give equal importance to each of these components

Physical Training

Pat and Joan are self-coached, doing some combination of swimming, biking, and running on six of seven days per week. Today, their training is based on an intermediate Ironman 70.3 program for those over age 50 from TrainingPeaks.

A typical week involves three open water swims in the lake next to their house in Gig Harbor, Washington. A bike or a run, some which take advantage of the hills near their house, often follow these swims. There are also days for the longer, slower run with a few hill repeats added for excitement.

Besides their long bike ride on the weekends, Pat bikes the 18 miles to and from work one day each week.

Include Strength Training for Endurance and Balance

Strength training is important for all triathletes. However, the Hogans have learned first-hand that it becomes even more important as we age.

Joan commented, “I can no longer just go out for a run. I have learned through various people, including physical therapists, that I need to spend the first 20-30 minutes doing exercises to strengthen my hips, hamstrings, and core muscles. Otherwise, ‘things’ breakdown.”

Related Post: Better Balance Makes A Stronger Triathlete

Cross Training for Both Endurance and Brain Health

“To improve the brain, we must continually challenge it. That’s why exercise that requires skilled coordination provides greater brain stimulation,” says Pat Hogan.

“That the brain changes as we challenge it is called neuroplasticity. However, if you do the same thing over and over again, the brain does not have a reason to adapt.”

This is one reason that triathlon, with its three technical sports, along with strength training, supports a healthy brain.

It is even better for our brain health when we combine triathlon training with activities outside endurance sports. Examples include ballroom dancing, music, learning a new language, and golf. (It encouraged me to learn that my brain can also benefit from practicing and playing golf with its challenges.)

Ballroom dancing provides diversity in motion and valuable exercise for their brains. Plus, it’s great fun for Pat and Joan and many couples.

Nutrition for the Senior Triathlete

Led by Joan’s passion for nutrition and brain health, the Hogan’s follow a vegetarian diet. This choice was initially based on environmental and animal welfare concerns. Nutrition was a third reason for choosing to follow this diet.

According to Joan, “No matter what type of diet you choose, your diet must it be high in plants, seven or eight servings of vegetables per day.”

She emphasized it is critical that seniors get enough protein in their diet to offset the trend toward muscle loss with age. The amounts of protein she recommends for seniors are greater than that for the average population.

  • women: at least 30 grams three times per day (plus 50% per meal more while training for an Ironman distance race).
  • men: at least 40 grams three times per day (plus 50% per meal more while training for an Ironman distance race)

Joan recommends consuming some of the protein before exercise, even if only half of that for a complete meal. “A half a banana with a slab of peanut butter or a protein smoothie before exercising is great.”

Here is an interesting point. According to recent research, it may even be more important for women than men to consume carbohydrates and protein before exercise..

Plant-Based Protein

According to Joan, the amounts of protein recommended for senior triathletes are available from plant-based sources. Her ‘go-to’ sources include organic soy (tofu, tempeh, and edamame), seitan (made from wheat gluten), peas, nuts, nut butters, and various beans. The Hogans sometimes supplement plant sources with whey, eggs (from their chickens), and cheese.

She also mentioned that a serving of pasta from chickpeas, black beans, and lentils is high in protein. “One serving of these contains the protein in a piece of meat.”

Joan warns it is more difficult, though not impossible, for those on a vegan diet to get the recommended amounts of protein. “It takes a lot of work to get the required amounts of protein.”

Related Post: What Masters Athletes Need To Know About Nutrition

The Healing Process Called Sleep

During sleep, our cerebral lymphatic system clears out from the brain, toxins and unused proteins generated during the waking hours. In the process, neurotransmitters in the brain are regenerated.

Interestingly, this regeneration only works during sleep, making it an important reason to get enough quality sleep each day.

Cutting sleep short prevents the healing from fully occurring. Complete healing is especially necessary for seniors because we already have a lower ‘neuronal reserve’ on which to rely as we age.

According to Pat and Joan, getting at least eight hours of sleep each day is so important that if you have to choose between sleeping and doing the workout, choose sleep. Don’t cut your sleep short because the benefits of your training will suffer from doing a workout without being adequately rested.

Related Post: Rest and Recovery: Why It’s Important for Senior Triathletes

Start Now and Never Stop!

If you are not doing a challenging exercise, start. That is the impassioned advice from the Hogan’s.

Don’t Wait . . .

“Our brain has a natural trajectory toward loss of balance and slowness of thought, if not actual dementia. The brain requires the medication of exercise to present this from happening. We call this medication Doesital (a term coined by Pat) and with diet, it is Doesital forte.

“Some say they will start later or take a break. We are all paddling upstream on a river, away from waterfalls. Once you go over the waterfalls, you can not go back up. We can avoid this irreversible fall with persistent exercise.”

And, Don’t Stop

Pat and Joan are committed to continuing in the sport of triathlon as long as they can, despite aging bodies.

Some think of our body as a machine with parts that require periodic replacement. However, this is not a correct view, according to Pat.

“Our bodies are much better than machines. Our joints are bio-mechanical, not simply mechanical, which means they adapt to stress and become stronger with use.”

Joan added, “Most problems that result in pain with exercise can be fixed without surgery.”

The author of “Runners Are Less At Risk Of Knee Arthritis Than Sedentary Populations” cites a 2018 paper which concludes:

“veteran marathon runners studied were actually around 50% less likely to develop knee arthritis than the non-runner comparison group.”

The author of this article also cited a paper published in the European Journal of Physiology which documents lower inflammation in knee joint fluid and blood serum following a 30 minute run.

Tips to Avoid Stopping

The Hogans have learned to be consistent with their training – exercise, diet, and rest. Here are tips they offer to help avoid quitting, especially when our body may initially seem to argue against exercising.

1. Make exercise a habit, part of your daily routine

When you have made something a habit, an unconscious part of your life, motivation is no longer required.

How do you make exercise a habit? Pat and Joan say that at the beginning it helps to “embrace some short-term discomfort as a means to longer term comfort”.

2. Train with a partner

The Hogans have the benefit of being each other’s spouse and training partner. They are able to better encourage each other because they understand one another’s schedules and the current demands upon them.

However, there are many other options for supporting senior triathletes on their journey, including Our Community on SeniorTriathletes.com, local triathlon clubs, and live and virtual coaches.

Let us know if you can use some help to find a support group for your triathlon journey.

Triathlon supports a healthy brain.
Pat and Joan Hogan after Ironman Salem. Having your spouse as your training partner for an Ironman distance triathlon solves a few of the challenges of committing to this training program.

3. Add some incentive by signing up for races

Paying the registration fee for a triathlon adds a new level of incentive to prepare for a triathlon. Most of us want to show up to the race knowing we have done what we could to complete the race, earn the t-shirt and finisher medal, and celebrate with other triathletes and our family and friends, even if they are watching from the sidelines – for now.

Final Remarks

Having seen the effects of a sedentary lifestyle and/or poor diet in their practice, Pat and Joan Hogan are on a crusade to convince those over age 50 to get into a habit of combining challenging physical exercise with an appropriate diet and quality sleep – for their body and their brain.

A little, short-term discomfort during exercise leads to a more comfortable life physically and a clearer mind. Besides, the training improves our thoughts of gratitude, confidence, positive attitude, hope, and inspiration that expand to all aspects of our daily life. 

Further Reading Related to Brain Health

Following are sources of additional information about the relationship between “challenging exercise” and brain health provided by Pat Hogan.


Spark: The Revolutionary New Science of Exercise and the Brain by John J. Ratey MD and Eric Hagerman.

The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer by Dr. Elizabeth Blackburn and Dr. Elissa Epel.

Move Your DNA: Restore Your Health Through Natural Movement by Katy Bowman.


How Exercise Benefits Brain Health by Vernon Williams, MD; US News & World Report.

4 Key Features of a “Sports Brain” by Vernon Williams, MD

Have Questions or Thoughts for Pat and Joan?

Share your questions and comments in the Comments section below.

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Triathlon Across the USA: State #45 – Oklahoma

Triathlon Across the USA: State #45 – Oklahoma

Barnsdall, Oklahoma; June 25, 2022 – Tulsa Sprint Triathlon, Twin Coves Beach at Birch Lake.

Our Oklahoma triathlon introduced us to the diversity of vegetation and terrain in the northeastern part of this state. I will also fondly remember the unique spectators along and on the bike course.

Planning the Oklahoma Triathlon

The date Joy and I had set for completing the ‘Triathlon Across the USA’ goal was in sight. In fact, I had committed to reaching it within the next year. I had six states in which to complete triathlons.

Meanwhile, a wedding and high school graduation meant we would return to Minnesota for at least two weeks in late May 2022. Late in 2021, I looked for triathlons that would fit into the next summer’s schedule.

The first two states on the itinerary were Oklahoma and Kansas, two states on back-to-back days at the end of June. Then, after a couple of weeks back in Minnesota, we would head west for the three remaining states in the west – California, Idaho, and Montana.

To avoid a price increase at the end of 2021, I registered for the Tulsa Tri on December 21st.

Previewing the Oklahoma Triathlon Course

A few months after committing to the Oklahoma triathlon, we learned that our son and his family would move from their home in Omaha, Nebraska, to a neighboring state. Their timing matched ours. They planned to leave Nebraska on the day of the Oklahoma triathlon.

We joined them for ten days prior to their move to help them pack and load the rented U-Haul truck. While this time was not exactly restful, it kept us active. It also helped develop some muscles not typically used as strenuously in my triathlon training.

By the Thursday evening before the Oklahoma triathlon, we had packed the truck with everything except one bed. A neighbor helped our son pack this after we left.

Since we would drive south from Omaha to the race venue on Friday afternoon and the pre-race packet pickup location was another 45 miles south of here, I opted to delay picking up the race packet until the morning of the triathlon.

Instead, we visited Twin Coves Beach and Birch Lake late Friday afternoon, the day before the race, to (1) make sure we knew the way to the park the next morning and (2) drive the bike course. We did the latter to check out the condition of the roads and check into memory sections of the course of which to be especially mindful.

The hills I saw while driving the bike course on Friday afternoon left an impression. In fact, some of these appeared in my dreams that night. Not exactly a nightmare, but close.

Oklahoma Triathlon Venue

The Tulsa Triathlon took place at Twin Coves Beach on Birch Lake about one and one-half miles outside Barnsdall, Oklahoma.

The man-made lake formed in 1977 when the US Army Corps of Engineers completed a dam on Birch Creek a short distance before it joined another small river, Bird Creek.

With various hardwood trees, shrubs, prairie grasses, and wildflowers covering the terrain around the lake, it was easy to see why the area is a popular year-round destination for outdoor enthusiasts.

8th Annual Tulsa Triathlon

The Tulsa Triathlon is one of several running and multisport events managed by the Tulsa Area Triathlon Club.

The sprint triathlon was part of a two-day event which included:

  • Saturday: Sprint triathlon, with options to race individually or as part of a team. Following the adult triathlon, there was a kid’s triathlon.
  • Sunday: Olympic and half-iron triathlons and aquabike races with the swim-bike distances of the Olympic and half-iron triathlon.

The advertised distances for the individual legs of this USAT-sanctioned sprint triathlon were:

  • Swim: 500 m (550 yards) – Actual: 538 m (588 yards)
  • Bike: 12 miles (19 km) – Actual: 12.6 miles (20 km)
  • Run: 3.1 miles (5 km) – Actual: 3. miles (5 km)

Actual distances shown above are from my Garmin Forerunner 920XT.

A Steamy Morning

I knew it was going to be a sweaty race as I stepped outside our hotel on race morning. Even at 5 am, the temperature and humidity were enough for me to perspire while simply stowing our overnight luggage in the van.

We left the hotel around 5:15 am to make the roughly 30-minute drive from Bartlesville to Barnsdall and Twin Coves Beach. Our goal was to reach Birch Lake in time for me to pickup my race packet at 6 am, setup my transition area, and get settled for the race set to begin at 7:10 am.


The water temperature in Birch Lake this morning was 85°F. This was significant since the race followed USAT rules. According to USAT rules, no one could wear a wetsuit during the swim.

The rule as written on the USAT website is:

  • 4.4 Wet suits. Each age group participant shall be permitted to wear a wet suit without penalty in any event sanctioned by USA Triathlon up to and including a water temperature of 78 degrees Fahrenheit. When the water temperature is greater than 78 degrees, but less than 84 degrees Fahrenheit, age group participants may wear a wet suit at their own discretion, provided however that participants who wear a wet suit within this temperature range shall not be eligible for prizes or awards. Age group participants shall not wear wet suits in water temperatures equal to or greater than 84 degrees Fahrenheit.” Source: USA Triathlon.

About ten minutes before the race began, I went for a short, warmup swim to jumpstart my heart rate.

Another goal of the swim was to learn about the lake bottom. I wanted to know if I would walk or run into the water on rocks. Or would the bottom be slippery or covered with weeds?

I learned that the bottom of Birch Lake was smooth, composed of soft clay, not slippery, and with no noticeable weeds. While the water was cloudy, it provided for a comfortable swim.

The triathlon began when a portion of the 156 swimmers, the so-called ‘first wave’, started their swim on this triangular course marked by two orange buoys.

Birch Lake at Twin Coves Beach, location for the swim during the Tulsa Triathlon.


One of the first things I noticed after mounting my bike was the temperature reported on my bike computer – 84°F. (By the end of the bike leg, around 50 minutes later, the temperature was 99°F.)

This course could well be the most hilly course of any I have biked during a triathlon. I had not expected this in Oklahoma. Fortunately, my bike was in great shape.

While riding this course, I learned that some people’s definition of rolling hills differ greatly from mine. Yes, these hills ‘rolled’ in that the course had a sinusoidal pattern, up then down. What made this different from normal rolling hills was their amplitude. My speed throughout the bike leg reflected the hilliness.

A Different Profile of Spectators

In many triathlons, residents along the bike path sit in lawn chairs and cheer on the racers. Today, there were no human spectators. However, there was a multitude of other spectators – a pair of horses who looked as if they were trying to figure what was happening. There were also the less interested but attentive cattle and goats keeping their eyes on racers, without actually cheering them on.

Near mile nine of the ride, as I was coming down a hill before a right-angle turn, a small turtle raced into the road. Apparently, it saw me coming as it reached the middle of the road. He froze, pulled in his head and legs, and lay still as I passed him.


The run course left the transition area near Birch Lake on a paved service road. Within the first mile, the initial road joined the main one leading to the park entrance.

With the temperature now approaching 100°F, my run actually alternated between running on flat and downhill sections of the course and walking on the upside of the hills.

After reaching the park entrance and stopping for a drink of water, I followed the course to the right for a short distance needed for the 5k distance. We turned around and returned in the direction of the finish line, this time making a short loop through one of the camping areas within the park.

After leaving the camping area, the finish line was a few hundred yards away – downhill.

After the Oklahoma Triathlon

By the time I crossed the finish line, I was a sweaty, dripping mess.

Joy graciously volunteered to drive for the three-hour trip to Wichita for the Mudwater Triathlon the next morning.

While we were eager to get started on our journey, I first took advantage of a generous supply of water, sports drinks, and fruit to start rehydrating.

I looked for a shower facility or a place in which to change clothes. Unfortunately, I didn’t find any. So, I spread a towel on the van’s passenger seat and stayed in my triathlon suit for the ride.

After experiencing the hills of northeastern Oklahoma during the Tulsa Tri, it was time to see the vast prairies, wind farms, oil derricks, and grazing cattle, also part of this state.

Race Firsts from the Oklahoma Triathlon

  • First triathlon in which I wore prescription glasses on the bike.
  • USAT rules prohibited wetsuits, another first.

Unique Spectators

Tell us in the Comments below about the most unique spectators you have had during a triathlon.

Our Stories

Our Stories

Inspiring, information-packed stories of men and women age 50 and over who compete in triathlon and other multisport endurance events

Triathlon Across the USA

If you are interested in following us on our journey across the USA while doing a triathlon in each state, click here.

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  • 101 Triathlons – John Dean’s Story
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  • A Healthy Retirement Plan – Mark Bartolomeo’s Story
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  • An Unlikely Triathlete – Craig Cross’s Story
    Is there certain experience you must have as a senior before competing in your first triathlon? According to Craig Cross, his Scottish ancestry makes him much more likely to be weightlifting than running. Furthermore, before his first […]
  • Christmas in October – Paul Zellner’s Story
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  • Too Stubborn to Quit – Marty Hunter’s Story
    Have you thought about doing your first triathlon in your 60s? Marty Hunter did and is now on her way to completing an Ironman 140.6 in her 70s. Introducing Marty Hunter Maureen ‘Marty’ Hunter lives in eastern […]
  • A Special Birthday Present – Juha Makitalo’s Story
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  • 5 Ideas for Staying Young – A Conversation with Tony Schiller
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  • Lessons in Ironman Triathlon Racing – Another Senior Triathlete’s Experience
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  • How Seniors Can Prepare for their First Triathlon
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  • Making Fitness a Lifestyle – Jeanne Minder’s Story
    From her earliest memories of growing up in South St. Paul, Minnesota, Jeanne Minder has been active. Her love for moving, whether through biking, running, swimming, walking, skiing, or you-name-it, has led to impressive accomplishments in triathlon. […]
  • “At Age 70, I Had 19 Days To My First Triathlon” – Pat Johnson’s Story
    The Villages, Florida – Can you prepare for your first sprint triathlon in less than 30 days, even at age 70? According to Pat Johnson, you can. She did it and is now an advocate for seniors […]
  • Exploring the USA Through Triathlon
    After completing my first triathlon in 2011, my wife, Joy, and I looked at each other and said, “Why not?”. Why not travel across the USA and complete a triathlon in each state? I was hooked. On […]
  • Aging Athletically: Becoming a Sexagenarian and a Triathlete
    By Jessica Perkins – In 2014 before my 58th birthday, I made the decision to complete a triathlon before my 60th birthday in June 2016. My decision wasn’t really out of the blue because for many prior […]
  • What If I Want to Do An Ironman Triathlon? – Tom Lipp’s Story
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  • “Training for My First Triathlon”- Liz Lawson’s Story
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  • ‘Live Like Josh’ – Terry Seidel’s Story
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  • 8 Reasons to Tri in the UK
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  • ‘Gotta Tri’ – Triathlon in The Villages, Florida
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  • My First Triathlon – Is This How George Plimpton Felt?
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  • Seniors are Increasingly Using Triathlon to Stay Fit . . . and Social
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  • Senior Triathlete Wins Women’s Division of National Winter Triathlon
    Senior triathlete Jan Guenther was the winner of the women’s division in the first USAT-sanctioned National Winter Triathlon Championship held January 31, 2016 in St. Paul, Minnesota, USA.  The senior triathlete men also turned in credible performances […]

Planning For A Triathlon At Higher Altitude

Planning For A Triathlon At Higher Altitude

How can you prepare for racing in a triathlon or other multisport endurance event that is at a significantly higher altitude than where you live and train?

While crossing the USA to complete a triathlon in every state, I have raced in western states, where the altitude on the courses was between 4,000 and 7,000 feet above sea level. Having trained in areas well below this, between sea level and 1,000 feet, I felt the effect of the altitude on race day.

Related post: Triathlon Across the USA: State #22 – New Mexico

Santa Fe, New Mexico sits at around 7,000 feet elevation. This picture was taken in the city’s art district.

What Happens When We Travel to Higher Altitude

As pictured in the chart below, the most important change is that the amount of oxygen in the air effectively decreases with altitude.

The people at APEX (Altitude Physiology Expeditions) describe it like this:

“At real altitude (in the mountains), the barometric pressure of the atmosphere is much lower than sea-level environments. The result is that oxygen molecules are spread further apart, lowering the oxygen content of each breath.”

While each air molecule contains the same amount of oxygen no matter the elevation, the density of air molecules decreases with altitude. This effectively reduces the oxygen content.

In other words, we draw in fewer air molecules with each breath at high altitude compared to a lower one. Each breath provides less oxygen for our muscles to burn fuel and create the power to move us through the water or along the road.

The result is that for a particular rate of perceived exertion (RPE), we will have less oxygen with which to power our muscles. We aren’t able to swim, bike, or run as fast as we are with more oxygen.

information about effective oxygen content with altitude for a triathlon at higher altitude
Effective Oxygen Content vs. Altitude (Data Sources: Mile High Training, Altitude Dream.com).

How I Selected the Altitude Range For The Graph

The 106° West Triathlon, first (and apparently only) held in 2016, was touted as the ‘Highest Triathlon in the World’ held at an elevation of 9,156 feet (2,791 meters). This race included quarter and half distances of the IRONMAN 140.6.

Let me know in the Comments (below) of any triathlons held at an altitude higher than this one.

Dealing With Altitude: Acclimatization and Adaptation

Two words – acclimatization and adaptation – are used to describe what happens when we travel to a higher altitude.


Acclimatization refers to the immediate and short term (up to two weeks) changes that occur with altitude.

This process begins immediately upon arriving at the higher altitude. The effect we recognize as breathing harder is called ‘respiratory alkalosis’.

Within a day, the hemoglobin concentration increases. We do not have more red blood cells at this point. However, the liquid component of our blood, the plasma, decreases to normalize the oxygen content in our blood. Lower oxygen content divided by lower plasma volume equals normal oxygen concentration (but not volume) in the blood.

Acclimatization continues over about two to three weeks.


Adaptation describes the longer-term effects, ones that take place over several months.

With extended time at altitude, our body will produce additional red blood cells through the production of the erythropoietin (EPO) hormone. Increasing the number of red blood cells increases the amount of oxygen available to our muscles and other organs.

It takes months, typically eight months according to what I have read, for the body to produce all the additional red blood cells and for adaptation to be complete.

‘Sleep High, Train Low’

There is evidence that the ideal adaptation comes from sleeping at high altitude (between 6,600 and 8,200 feet, which is equal to 2,000 and 2,500 meters) and training at or near sea level.

Sleeping high leads to an increase in hemoglobin. Training low allows for more intense training to increase the key parameter for endurance, VO2max.

How Does Age Affect These Changes?

As seniors in the multi-sport community, we know that age changes the way we train compared with our younger competitors. But, does altitude give us an advantage or create a disadvantage on race day?

Altitude may be one of the few factors that are on our side. According to a report titled Effect of High-Altitude Exposure in the Elderly, age does not seem to be a factor in adjusting to the higher elevation. According to the authors of this study:

“Fortunately, the elderly appear to acclimatize well and after 5 days of acclimatization were physiologically almost indistinguishable from sea level. Thus, aging does not appear to impair the physiological adaptive response to either acute or chronic hypoxia, even in the presence of substantial comorbidity.”

Beautiful mountain view with the caption 'Racing at a higher altitude can mean experiencing some of the most awe-inspiring places on this planet.'
Racing in a triathlon at a higher altitude can mean experiencing some of the most awe-inspiring places on this planet.

What Can You Do To Prepare For A Triathlon At Higher Altitude?

The audience for this post is beginner and intermediate age group athletes. Therefore, I am assuming you will not invest the time and money for training at an altitude camp for several weeks.

However, even if you do, there is no guarantee of increased performance, according to many coaches and scientists. Some people do not adapt. And, the training must be tailored to the individual for it to have significant benefit. (Continue reading for more information on high altitude training.)

Nevertheless, there are ways you can prepare for a triathlon at a higher altitude.

1. Arrive at the race altitude from 2 to 14 days before the race

In a paper titled “Timing of Arrival and Pre-acclimatization Strategies for the Endurance Athlete Competing at Moderate to High Altitudes”, authors Robert F. Chapman, Abigail S. Laymon, and Benjamin D. Levine (see the complete reference in the quotation below) conclude that arriving at the race altitude 14 days before the event is the most ideal. However, they also acknowledge that this amount of time will not be practical for most, given the cost and other responsibilities related to family and work.

Arriving the night before the competition, on the other hand, is a risky strategy. This is especially true if you suffer from any disruption in sleep, a critical component of acclimatization.

While longer is better, 2 to 14 days before the race at the altitude of the event reduces performance declines. This comes from settling into a consistent pattern of quality sleep and reducing the deleterious physiological effects of altitude, such as a reduction in plasma volume.

Performance decrement at altitude appears to decline with each day of altitude residence (up to ~14 days).

Chapman, Robert F., Abigail S. Laymon, and Benjamin D. Levine, “Timing of Arrival and Pre-acclimatization Strategies for the Endurance Athlete Competing at Moderate to High Altitudes”, High Altitude Medicine & Biology, Volume 14, Number 4, 2013, pp. 319-324.
Hungry Horse Reservoir and Dam near Glacier National Park in northwestern Montana. By the time I competed in the Montana triathlon, I had stayed above 5,000 feet elevation for over two weeks.

2. Pay extra attention to factors that degrade at altitude

This is in line with the previous point, but worth repeating.

First, stay hydrated. Along with lower effective oxygen, higher altitude also means lower relative humidity of the air. Therefore, fluid loss is greater than in higher humidity regions.

Also, the higher altitude may compromise your sleep. According to this TrainingPeaks article, getting sleep during the initial time at higher altitude can be difficult for some. Some people initially suffer from acute mountain sickness (AMS). Symptoms of AMS include headaches, nausea, dizziness, and fatigue.

Give yourself time to become rested.

3. Pace yourself on race day

According to an article in Triathlete magazine, our VO2max decreases by 7.7 percent for every 1,000 meters of altitude. If you are able, go for a swim, bike, or run before the race to get a sense of how the altitude is affecting your performance. Otherwise, plan to go out slower to avoid having your body put the brakes on unexpectedly.

Remember to ease into the altitude and pace yourself as your body becomes acclimatized.

4. Train to offset performance declines that come with altitude

As we just read, our VO2max decreases with altitude even after several days of acclimatization. However, one strategy for mitigating the decline is to increase your VO2max.

In the last weeks before traveling to the higher altitude, perform harder sessions, like hill repeats, at your typical training altitude. These will simulate the feeling of working harder that will accompany racing at higher altitude.

If you want to learn more about the ins and outs of training at high altitude, I recommend listening to this podcast from Fast Talk Labs.

Final Comments

The human body is amazing in its ability to adapt to different environments. However, the comments on various websites and in academic research papers continually remind me we are all different.

Be sure to discuss with your coach or your doctor any plans to race in a triathlon or other multisport endurance event at higher altitude.

What Has Been Your Experience With Racing At Higher Altitude?

Please share in the Comments below what you have learned about training and racing in a triathlon at higher altitude?