The Effects of Exercise Training on Plasma Volume Variations: A Systematic Review

Abstract

The aim of this systematic review was to summarize the evidence on the acute and long-term effects of exercise training on PV, in both trained and untrained individuals and to examine associations between changes in %PVV and change in physical/physiological performance. Despite the status of participants and the exercise duration or intensity, all the acute studies reported a significant decrease of PV (effect size: 0.85<d<3.45, very large), and ranged between 7 and 19.9%. In untrained individuals, most of studies reported a significant increase of PV in response to different kind of training including endurance training and high intensity interval training (effect size: 0.19<d<3.52, small to very large), and ranged from 6.6 to 16%. However, in trained individuals the results are equivocal. We showed that acute exercise appears to induce a significant decrease of PV in both healthy untrained and trained individuals in response to several exercise modalities. Moreover, there is evidence that long-term exercise training induced a significant increase of PV in healthy untrained individuals. However, it seems that there is no consensus concerning the effect of long-term exercise training on PV in trained individuals.

Key words

hemoglobin - hematocrit - blood volume - red blood cells

Publication History

Received: 14 April 2021

Accepted: 11 October 2021

Accepted Manuscript online:
12 October 2021

Article published online:
17 March 2023

• References

• 1 Skalenius M, Zattsson CM, Dahlberg P. et al. Performance and cardiac evaluation before and after a 3-week training camp for 400-meter sprinters – An observational, non-randomized study. PLoS One 2019; 14: e0217856
• 2 Aagaard P, Sahlen A, Braunschweig F. Performance trends and cardiac biomarkers in a 30-km crosscountry race, 1993–2007. Med Sci Sports Exerc 2012; 44: 894-899
• 3 Malm C, Jakobsson J, Isaksson A. Physical Activity and Sports-Real Health Benefits: A Review with Insight into the Public Health of Sweden. Sports (Basel) 2019; 7: 127
• 4 Kanstrup IL, Ekblom B. Acute hypervolemia, cardiac performance, and aerobic power during exercise. J Appl Physiol Respir Environ Exerc Physiol 1982; 52: 1186-1191
• 5 McGawley K, Bishop DJ. Oxygen uptake during repeated-sprint exercise. J Sci Med Sport 2015; 18: 214-218
• 6 Ahlgrim C, Pottgiesser T, Kron J. et al. Relations between haemoglobin mass, cardiac dimensions and aerobic capacity in endurance trained cyclists. J Sports Med Phys Fitness 2009; 49: 364-371
• 7 Pottgiesser T, Schumacher YO. Current strategies of blood doping detection. Anal Bioanal Chem 2013; 405: 9625-9639
• 8 Gledhill N DE, Quinney HA. Blood volume, aerobic power, and endurance performance: potential ergogenic effect of volume loading. Clin J Sport Med 2000; 10: 59-66
• 9 Steiner T, Wehrlin JP. Does hemoglobin mass increase from age 16 to 21 and 28 in elite endurance athletes?. Med Sci Sports Exerc 2011; 43: 1735-1743
• 10 Sitkowski D, Szygula Z, Pokrywka A. et al. Interrelationships between changes in erythropoietin, plasma volume, haemoglobin concentration, and total haemoglobin mass in endurance athletes. Res Sports Med 2018; 26: 381-389
• 11 Kanstrup I, Ekblom B. Blood volume and hemoglobin concentra- tion as determinants of maximal aerobic power. Med Sci Sports Exerc 1984; 16: 256-262
• 12 Coyle EF, Hemmert MK, Coggan AR. Effect of detraining on cardiovascular responses to exercise: role of blood volume. J Appl Physiol (1985) 1986; 60: 95-99
• 13 Coyle EF, Hopper MK, Coggan AR. Maximal oxygen uptake rela- tive to plasma volume expansion. Int J Sports Med 1990; 11: 116-119
• 14 Krip B, Gledhill N, Jamnik V. et al. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc 1997; 29: 1469-1476
• 15 Sawka N, Convertino A, Eichner R. et al. Blood volume: importance and adaptations to exercise training, environmental stresses, and trauma/sickness. Med Sci Sports exerc 2000; 32: 332-348
• 16 Rhibi F, Prioux J, Attia MB. et al. Increase interval training intensity improves plasma volume variations and aerobic performances in response to intermittent exercise. Physiol Behav 2019; 199: 137-145
• 17 Warburton DE, Haykowsky MJ, Quinney HA. Blood volume expansion and cardiorespiratory function: effects of training modality. Med Sci Sports Exerc 2004; 36: 991-1000
• 18 Pavón DJ, Lavie CJ. High-intensity intermittent training versus moderate-intensity intermittent training: is it a matter of intensity or intermittent efforts. Br J Sports Med 2017; 51: 1319-1320
• 19 Zouhal H, Vincent S, Moussa E. et al. Influence of training status on plasma volume variations and plasma lactate concentrations in response to supramaximal exercise. Biol Sport 2007; 24: 339-356
• 20 Deschenes MR, Hillard MN, Wilson JA. et al. Effects of gender on physiological responses during submaximal exercise and recovery. Med Sci Sports Exerc 2006; 7: 1304-1310
• 21 Berthoin S, Allender H, Baquet G. et al. Plasma lactate and plasma volume recovery in adults and children following high-intensity exercises. Acta Paediatr 2003; 3: 283-290
• 22 Moussa E, Prioux J, Delamarche P. et al. Plasma volume variations induced by sprint exercise in sprinters, endurance-trained and untrained male subjects. Sci Sports 2003; 18: 202-108
• 23 Altenkirch HU, Gerzer R, Kirsch KA. et al. Effect of prolonged physical exercise on fluid regulating hormones. Eur J Appl Physiol Occup Physiol 1990; 61: 209-213
• 24 Marieb EN, Hoehn K. Human Anatomy & Physiology. Pearson Benjamin Cummings, San Francisco 2007; 420-425
• 25 El-Sayed MS, Davies B, Morgan DB. Vasopressin and plasma volume response to submaximal and maximal exercise in man. J Sports Med Phys Fitness 1990; 4: 420-425
• 26 Cinar V, Cengiz S, Pala R. et al. Effect of football practices on certain blood values of athletes. Adv Environ Biol 2013; 7: 924-927
• 27 Demiriz L, Durmuşlar MC, Misir AF. Prevalence and characteristics of supernumerary teeth: A survey on 7348 people. J Int Soc Prev Community Dent 2015; 5: 39-43
• 28 Pancar Z, Özdal M, Çinar V. The effect of 4-weekly low intensity physical activity program in thyroid hormone levels in obese and overweight children. European Journal of Physical Education and Sport Science 2017; 3: 1-8
• 29 Londeann R. Low heamatcrits during basic training athlete’s anemia. N Engl J Med 1987; 299: 1191-1192
• 30 Hellsten Y, Nyberg M. Cardiovascular adaptations to exercise training. Compr Physiol 2016; 6: 1-32
• 31 Saltin B, Nazar K, Costill DL. et al. The nature of the training response; peripheral and central adaptations of one-legged exercise. Acta Physiol Scand 1976; 96: 289-305
• 32 Zavorsky GS. Evidence and possible mechanisms of altered maximum heart rate with endurance training and tapering. Sports Med 2000; 29: 13-26
• 33 Ben Abderrahman A, Prioux J, Chamari K. et al. Running interval training and estimated plasma-volume variation. Int J Sports Physiol Perform 2013; 8: 358-365
• 34 Saidi K, Zouhal H, Rhibi F. et al. Effects of a six-week period of congested match play on plasma volume variations, hematological parameters, training workload and physical fitness in elite soccer players. PLoS One 2019; 14: e0219692
• 35 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ 2009; 339: b2535
• 36 Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma and red cells in dehydration. J AppI Physiol 1974; 37: 247-248
• 37 Beaumont WV, Greenleaf JE, Johos L. Disproportional changes in haematocrit, plasma volume and proteins during exercise and bed rest. J Appl Physiol 1972; 33: 55-61
• 38 Maughan RJ, Whiting PH, Davidson RJL. Estimation of plasma volume changes during marathon running. Br J Sports Med 1985; 19: 138-141
• 39 Maher CG, Sherrington C, Herbert RD. et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83: 713-721
• 40 Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Academic Press; 1969
• 41 Pugh LGCE. Blood volume changes in outdoor exercise of 8–10 hour duration. J Physiol 1969; 200: 345-351
• 42 Gillen CM, Lee R, Mack GW. et al. Plasma volume expansion in humans after a single intense exercise protocol. J Appl Physiol (1985) 1991; 71: 1914-1920
• 43 Sellami M, Chamari K, Zagatto AM. et al. Racial differences in hemoglobin and plasma volume variation: Implications for muscle performance and recovery. Ethn Health 2019; 24: 182-193
• 44 Sellami M, Ben Abderrahmen A, Dhahbi W. et al. Hemoglobin, hematocrit and plasma volume variations following combined sprint and strength: Effect of advanced age. Sci Sports 2021; 36: e13-e21
• 45 Uchida K, Kamijo YI, Ikegawa S. et al. Interval walking training and nutritional intake to increase plasma volume in elderly. Med Sci Sports Exerc 2018; 50: 151-158
• 46 Pereira ER, De Andrade MT, Mendes TT. et al. Evaluation of hydration status by urine, body mass variation and plasma parameters during an official half-marathon. J Sports Med Phys Fitness 2017; 57: 1499-1503
• 47 Tsampoukos A, Stokes K, Nevill M. Separate and combined influence of posture and sprint running on plasma volume changes. Eur J Sport Sci 2014; 14: 267-274
• 48 Berthoin S, Pelayo P, Baquet Marais G. et al. Effets des variations du volume plasmatique sur les concentrations de lactate et leur cinétique de récupération après des exercices maximaux et supramaximaux. Sci Sports 2000; 15: 31-39
• 49 Berthoin S, Pelayo P, Baquet G. et al. Plasma lactate recovery from maximal exercise with correction for variations in plasma volume. J Sports Med Phys Fitness 2002; 42: 26-30
• 50 Hebestreit H, Meyer F, HctayHctay G. et al. Plasma metabolites, volume and electrolytes following 30-s high-intensity exercise in boys and men. Eur J Appl Physiol 1996; 72: 563-569
• 51 Green HJ, Sutton JR, Coates G. et al. Response of red cell and plasma volume to prolonged training in humans. J Appl Physiol (1985) 1991; 70: 1810-1815
• 52 Lobigs LM, Garvican-Lewis LA, Vuong VL. et al. Validation of a blood marker for plasma volume in endurance athletes during a live-high train-low altitude training camp. Drug Test Anal 2018; 10: 1176-1183
• 53 Convertino VA. Blood volume: its adaptation to endurance training. Med Sci Sports Exerc 1991; 23: 1338-1348
• 54 Branch JD, Pate RR, Bourque SP. et al. Exercise training and intensity does not alter vascular volume responses in women. Aviat Space Environ Med 1999; 70: 1070-1076
• 55 Stephenson BT, Tolfrey K, Goosey-Tolfrey VL. Mixed active and passive, heart rate-controlled heat acclimation is effective for paralympic and able-bodied triathletes. Front Physiol 2019; 20: 1214
• 56 Schumacher YO, Pottgiesser T, Ahlgrim C. et al. Haemoglobin mass in cyclists during stage racing. Int J Sports Med 2008; 29: 372-378
• 57 Derbré F, Botcazou M, Vincent S. et al. Effets de l’entraînement de sprint et du désentraînement sur les variations du volume plasmatique induites par un test supramaximal chez des adolescents. Sci Sports 2009; 24: 166-172
• 58 Kataoka Y, Kamijo YI, Ogawa Y. et al. Effects of hypervolemia by protein and glucose supplementation during aerobic training on thermal and arterial pressure regulations in hypertensive older men. J Appl Physiol (1985) 2016; 121: 1021-1031
• 59 Montero D, Breenfeldt-Andersen A, Oberholzer L. et al. Erythropoiesis with endurance training: Dynamics and mechanisms. Am J Physiol Regul Integr Comp Physiol 2017; 312: R894-R902
• 60 Mtinangi BL, Hainsworth R. Effects of moderate exercise training on plasma volume, baroreceptor sensitivity and orthostatic tolerance in healthy subjects. Exp Physiol 1999; 84: 121-130
• 61 Green HJ, Sutton JR, Coates G. et al. Response of red cell and plasma volume to prolonged training in humans. J Appl Physiol (1985) 1991; 70: 1810-1815
• 62 Bejder J, Andersen AB, Goetze JP. et al. Plasma volume reduction and hematological fluctuations in high-level athletes after an increased training load. Scand J Med Sci Sports 2017; 27: 1605-1615
• 63 Lobigs LM, Garvican-Lewis LA, Vuong VL. et al. Validation of a blood marker for plasma volume in endurance athletes during a live-high train-low altitude training camp. Drug Test Anal 2018; 10: 1176-1183
• 64 Menz V, Strobl J, Faulhaber M. et al. Effect of 3-week high-intensity interval training on VO2max, total haemoglobin mass, plasma and blood volume in well-trained athletes. Eur J Appl Physiol 2015; 115: 2349-2356
• 65 Tayebi SM, Ghanbari-Niaki A, Hanachi P. et al. The effect of Ramadan fasting and weight-lifting training on plasma volume, glucose and lipids profile of male weight-lifters. Iran J Basic Med Sci 2010; 13: 57-62
• 66 Heinicke K, Heinicke I, Schmidt W. et al. A three-week traditional altitude training increases hemoglobin mass and red cell volume in elite biathlon athletes. Int J Sports Med 2005; 26: 350-355
• 67 Rolls BJ, Phillips Paddy A, Phil D. Aging and disturbances of thirst and fluid balance. Nutr Rev 1990; 48: 137-144
• 68 Phillips AM, Salkoff LB, Kelly LE. A neural gene from Drosophila melanogaster with homology to vertebrate and invertebrate glutamate decarboxylases. J Neurochem 1993; 61: 1291-1301
• 69 Lundvall J, Mellander S, Westling H. et al. Fluid transfer between blood and tissues during exercise. Acta Physiol Scand 1972; 85: 258-269
• 70 Wilkerson DP, Rittweger J, Berger NJ. et al. Influence of recombinant human erythropoietin treatment on pulmonary O2 uptake kinetics during exercise in humans. J Physiol 2005; 568: 639-652
• 71 Nevill AM, Balmer NJ, Williams AM. The influence of crowd noise and experience upon refereeing decisions in football. Psychol Sport Exerc 2002; 3: 261-272
• 72 Retallick CJ, Baker JS, Williams SR. et al. Plasma volume response to 30-s cycle ergometry: Influence on lipid and lipoprotein. Med Sci Sports Exerc 2007; 39: 1579-1586
• 73 Tsampoukos A, Peckham EA, James R. et al. Effect of menstrual cycle phase on sprinting performance. Eur J Appl Physiol 2010; 109: 659-667
• 74 Whittlesey MJ, Maresh CM, Armstrong LE. et al. Plasma volume responses to consecutive anaerobic exercise tests. Int J Sports Med 1996; 17: 268-271
• 75 Stokes KA, Nevill ME, Hall GM. et al. The time course of the human growth hormone response to a 6 s and a 30 s cycle ergometer sprint. J Sports Sci 2002; 20: 487-494
• 76 Sjøgaard G, Saltin B. Extra- and intracellular water spaces in muscles of man at rest and with dynamic exercise. Am J Physiol 1982; 243: R271-R280
• 77 Carter R, Watenpaugh DE, Wasmund WL. et al. Muscle pump and central command during recovery from exercise in humans. J Appl Physiol (1985) 1999; 87: 1463-1469
• 78 Crisafulli A, Orrù V, Melis F. et al. Hemodynamics during active and passive recovery from a single bout of supramaximal exercise. Eur J Appl Physiol 2003; 89: 209-216
• 79 Raine NM, Cable NT, George KP. et al. The influence of recovery posture on post-exercise hypotension in normotensive men. Med Sci Sports Exerc 2001; 33: 404-412
• 80 Costill DL, Fink WJ. Plasma volume changes following exercise and thermal dehydration. J Appl Physiol 1974; 37: 521-525
• 81 Nielsen B, Kubica R, Bonnesen A. et al. Physical work capacity after dehydration and hyperthermia. Scandinavian Journal of Sports Sciences 1981; 3: 2-9
• 82 Cohn SN, Ahrens TJ. Dynamic tensile strength of lunar rock types. J Geophys Res 1981; 86: 1794-1802
• 83 Selby GB, Eichner ER. Hematocrit and performance: the effect of endurance training on blood volume. Semin Hematol 1994; 31: 122-127
• 84 Van Beaumont W, Underkofler S, van Beaumont S. Erythrocyte volume, plasma volume, and acid-base changes in exercise and heat dehydration. J Appl Physiol Respir Environ Exerc Physiol 1981; 50: 1255-1262
• 85 Harrison MH. Effects of thermal stress and exercise on blood volume in humans. Physiol Rev 1985; 65: 149-209
• 86 Jabbour G, Iancu HD, Zouhal H. et al. High-intensity interval training improves acute plasma volume responses to exercise that is age dependent. Physiol Rep 2018; 6: e13609
• 87 Carroll JF, Convertino VA, Wood CE. et al. Effect of training on blood volume and plasma hormone concentrations in the elderly. Med Sci Sports Exerc 1995; 27: 79-84
• 88 Hodges ANH, Sporer NC, Lane KN. et al. One session of interval work does not alter ˙VO_2max, peak power or plasma volume. Eur J Sport Sci 2010; 10: 285-189
• 89 Silva JR, Rebelo A, Marques F. et al. Biochemical impact of soccer: an analysis of hormonal, muscle damage, and redox markers during the season. Appl Physiol Nutr Metab 2013; 39: 432-438
• 90 Heisterberg MF, Fahrenkrug J, Krustrup P. et al. Extensive monitoring through multiple blood samples in professional soccer players. J Strength Cond Res 2013; 27: 1260-1271
• 91 Gibala MJ, Little JP, Macdonald MJ. et al. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol 2012; 590: 1077-1084
• 92 Green HJ, Hughson RL, Thomson JA. et al. Supramaximal exercise after training-induced hypervolemia. I: gas exchange and acid-base balance. J Appl Physiol (1985) 1987; 62: 1944-1953
• 93 Alis R, Sanchis-Gomar F, Lippi G. et al. Microcentrifuge or automated hematological analyzer to assess hematocrit in exercise? Effect on plasma volume loss calculations. J Lab Autom 2016; 21: 470-477
• 94 Kenney WL, Wilmore JH, Costill DL. Physiol Sport Exer. Champaign, IL: Human Kinetics; 7th ed. 2020
• 95 Kargotich S, Godman C, Keast D. et al. The influence of exercise-induced plasma volume changes on the interpretation of biochemical parameters used for monitoring exercise, training and sport. Sports Med 1998; 26: 101-117
• 96 Gibala MJ, Little JP, Van Essen M. et al. Short-term sprint interval versus traditional endurance training: Similar initial adaptations in human skeletal muscle and exercise performance. J Physiol 2006; 15: 901-911
• 97 Meyer T, Meister S. Routine blood parameters in elite soccer players. Int J Sports Med 2011; 32: 875-881
• 98 Hansen L, Klausen K. Development of aerobic power in pubescent male soccer players related to hematocrit, hemoglobin and maturation: A longitudinal study. J Sports Med Phys Fitness 2004; 44: 219
• 99 Burke J, Thayer R, Belcamino M. Comparison of effect of two interval-training programs on lactate and ventilator thresholds. Br J Sports Med 1994; 28: 18-21
• 100 Bonne TC, Doucende G, Fluck D. et al. Phlebotomy eliminates the maximal cardiac output response to six weeks of exercise training. Am J Physiol Regul Integr Comp Physiol 2014; 306: R752-R760
• 101 Schmidt W, Maassen N, Trost F. et al. Training induced effects on blood volume, erythrocyte turnover and haemoglobin oxygen binding properties. Eur J Appl Physiol 1988; 57: 490-498
• 102 Schumacher YO, Pottgiesser T, Ahlgrim C. et al. Haemoglobin mass in cyclists during stage racing. Int J Sports Med 2008; 29: 372-378