Table 2

Recommendations for optimising preparations of Olympic and Paralympic athletes in snow-sport events to challenges associated with elevated altitude, cold temperatures, travel and jetlag at the 2022 Beijing Olympic and Paralympic Games based on Sandbakk et al49 with minor modifications

ChallengeGeneral applied practical recommendations—long termGeneral applied practical recommendations—short term
  • In advance, train for at least 60 days and participate in several competitions at this elevation or higher.

  • Individualise training, recovery, pacing, technique and nutrition appropriately.

  • As close in time prior to the Games as possible, train for 0–14 days at the altitude of competition, either at the actual venue for the Games or in Europe or Asia (which will require later adjustment of the circadian rhythm).

  • Alternatively, live and train for 14–21 days above 2000 m, followed by 7–10 days at ~1700 m. For maximal erythropoiesis, blood levels of ferritin should be >30 ng/mL prior to exposure to altitude and oral supplementation with iron (~100–200 mg daily) individualised during this exposure.

  • Acclimatisation and performance at elevated altitudes with maintenance of good health is dependent on appropriate nutrition and hydration, and good sleep hygiene and routines

  • Adapt individualised warm-up procedures, pacing strategies and clothing to different temperatures and potentially changing environmental conditions in an appropriate manner.

  • Wear clothing that ensures maintenance of core body temperature.

  • Develop a strategy for maintaining body temperature effectively during the interval between warm-up and competition.

  • Adapt individualised warm-up and pacing to prevailing environmental conditions, especially at the beginning of a race.

  • Preparation must be made for treatment of asthmatic symptoms when respiration is rapid at cold temperatures.

Travel and jetlag
  • Exposure yourself to (day)light in a manner that optimises adjusting your circadian rhythm and consider dietary supplementation with 2–5 mg melatonin, if needed.

  • Schedule meals and social activities on the basis of the local time.

  • Short (20–30 min) naps can promote recovery and alertness.

  • During the initial few days, total training load should be reduced and intensive high-intensity training avoided.

  • Arrive at least 1 day earlier for each hour by which your time zone differs from that in Beijing.

  • Before departure, shift your sleep and eating schedule by 0.5–1 hour daily for three or 4 days towards the anticipated schedule in Beijing.

  • Travelling east during the afternoon and night increases the chances of sleeping well during the flight.

  • Avoid dehydration by drinking appropriate volumes of fluids free from alcohol or caffeine.

  • To minimise the high risk of infection associated with air travel, try to avoid crowds and use a face mask when it is difficult to keep distance, wash your hands frequently.

Athlete health and sport safety
  • Monitor injuries and illnesses in detail, both during training and the Olympic/Paralympic Games themselves to identify the extent of the problem.

  • Work proactively with injury and disease prevention, athlete health, and education within the Olympic/Paralympic movement and the National Olympic/Paralympic Committees.

  • Allow athletes to train on and test the actual competition courses in advance.

  • Do not hesitate to cancel or postpone competitions if the weather is too bad or other conditions poor.

  • Adhere to the COVID-19 regulations put in place specifically for the Paralympic Games.

  • In addition, we here provide general recommendations for athlete health and sport safety at the 2022 Beijing Olympic and Paralympic Games.