The objectives of the study were to determine regional changes in body composition, energy expenditure by means of doubly labeled water, and net energy balance during exposure to high and extreme altitudes (5,300-8,848 m). This study focuses on a subset of subjects who consumed the doubly labeled water (three base camp personnel and seven climbers). Regional body composition was determined by measuring skinfold thicknesses and circumferences at 10 different sites on the body. Energy expenditure was measured by doubly labeled water excretion. Discrepancies between actual energy expenditure and data obtained from diet records and body weight changes suggested a chronic underreporting of dietary energy intake, especially by those subjects who reached the highest altitudes. This underreporting may be due in part to diminished cognition or to a preferential focus on survival, rather than on filling out diet records accurately. Mean adjusted dietary intakes were 10.50 +/- 0. 65 MJ/d (2510 +/- 155 kcal/d) for those who remained at base camp, and 20.63 +/- 6.56 MJ/d (4931 +/- 1568 kcal/d) for those who climbed above base camp. Energy expenditure averaged 2.5-3.0 times sea level resting energy expenditure. Differential changes in regional body composition suggested a preferential loss of fat mass and a relative sparing of muscle mass, despite insufficient energy intake to maintain body weight.

The objectives of the study were to determine total energy intakes, distribution of energy derived from the macronutrients, and the effects of increasing altitudes on energy and macronutrient consumption during exposure to high altitudes. High fat, low carbohydrate diets (35% and 50% of energy, respectively) or low fat, high carbohydrate diets (20% and 65% of energy, respectively) were provided to two groups of subjects for a 3-wk period. Groups then consumed the alternate diet for 3 wk, followed by a return to the original diet for the remaining 3 wk of the study. Free choice of individual items and amounts within each diet was permitted. Intake of food and fluid was determined by means of monitored entries in daily food records. Five subjects remained at Base Camp (5300 m) and 10 subjects climbed to altitudes up to and including the summit of Mt. Everest (8848 m). Subjects consumed an average of 10.22 +/- 4.57 MJ/d (2442 +/- 1092 kcal) energy while at Base Camp, with climbers consuming significantly more than Base Camp personnel [11.89 +/- 4. 88 vs. 7.87 +/- 2.98 MJ/d (2841 +/- 1167 vs. 1881 +/- 713 kcal/d), P 0.05). Contrary to previous reports, subjects in this study did not shift their food selections away from the high fat items towards high carbohydrate items.

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