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energy stores, and environmental conditions determine these energy needs. Because the energy requirements for work at high altitudes are higher and appetite tends to decline, energy intakes are often inadequate to meet these increases.

Chapter 21 presents evidence suggesting that there is increased oxidative stress at high altitudes, which impairs blood flow and physical performance. Inadequate levels of antioxidants may impair metabolic functions at altitude, and some studies show that vitamin E is beneficial.

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