Jerry arrived into my office during a Wednesday morning rainstorm following his breakfast meeting with a fellow mountaineer. While I was watching him through my large bay window, I noticed immediately his tension as he lacked that typical relaxed flowing gait. His arms were not swinging at their normal rate while his chin was dropped a bit. There was obviously a concern that was atypical for this lean climbing machine.
When I walked in I said, "You look like you just fought a Yeti, what's going on?" They just finished an intense discussion on a study released that included the latest on the performance effects caffeine and alcohol could have on their high altitude success. He had read the review the previous evening, and immediately sent it to me later that night with the following phrase, "What the deuce?". Thankfully, I am up on the latest mechanisms of such issues especially since mountaineering is one of my favorites areas of study.
He brought to my attention his worry about the amounts. He really enjoyed his bourbon and dark roast coffees while he acclimatized. This had potentially been an issue in the past on some summit bids, but I kept them to myself since there were other variables that may have lead to the physical fatigue. At 46, he was in his later years of his trade, but still in fantastic fitness to achieve his goals. Coffee and alcohol were part of his routine and often a religion for their culture. His buddy, John, followed the sciences to the letter and made decisions that correlated with what would achieve optimally success, so he told Jerry he needed to quit both.
Jerry immediately refused and for the first time he and John were having their first big disagreement. I felt like a mediator for the first few minutes, but the opposite side was not there. Being a science nerd myself, I understood where John was coming from, but also knew that there are always limits to work in as well as timing. We needed to dig into the details of the study while I maintained a visible concern and understanding for Jerry.
The study review "The effects of caffeine, nicotine, ethanol, and tetrahydrocannabinol on exercise performance" by Pesta, Domink H, et al, broke down the mechanisms of actions of the four variables with their effects on performance. The key concepts that relate to Jerry's situation are caffeine's role in glycogen recovery and endurance performance via lipolysis and alcohol's role as detriment to motor function and recovery.
As we dive into the discussion, I lean toward him with my elbows across my knees as he sits nearly erect in his chair with the rain beating down behind him. Some variables just need to be tweaked a bit I told him. "We can figure out what is optimal for you during each climb. Let's look further into the study to see what fits best. How does that work for you?" He agreed.
Two variables for the caffeine that could benefit are amounts per day and timing per day. The first is to maintain near 6 milligrams per kilogram of body mass. This is the general consensus across the board. The second is to focus on drinking the most following the day's climb along with carbohydrates. Now, the challenging topic. At this moment, I knew we would have to remove or greatly limit one of his all time favorite pleasures on the mountain - bourbon. My face grew naturally nervous as I had to break the news. I refrained from mentioning the alcohol-motor issue since I knew he was intelligent enough to understand that component. Instead, I discussed the reduction in protein synthesis which could have long-term challenges in his ability to recover at high altitude. Telling him the implications of lost recovery could reduce muscle tissue over long periods thus reducing force output in his climbs. "Drinking alcohol is akin to putting acid in your muscles." This lit his eyes up immediately.
"So you are telling me, I could be getting even weaker than I normally do?".
"Yes, Jerry that is what I am telling you."
"Yes. Done. No, more bourbon on the mountain. I can celebrate when I get back down to base camp. That will just make it taste that much better."
"So, let's recap. Small amounts of coffee throughout the day and the largest portion at the end of the day with carbohydrates for a total of your body mass times 6 milligrams. And no more bourbon until you return from the summit?"
"That's it. I love what I do more than what I drink."
"Are you and John going to be ok?"
"I think this will make him happy. He will still get some coffee."
Pesta, Dominik H., Angadi, Siddhartha S., Burtscher, Martin, and Roberts, Christina K., The effects of caffeine, nicotine, ethanol, and tetrahydrocannabinol on exercise performance. PubMed, http://www.ncbi.nlm.nih.gov/pubmed/24330705