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At moderate altitude, physiological responses (HR and blood lactate at 100 W) at a submaximal exercise intensity of 100 W remained unchanged or were even slightly reduced in both groups. Conclusions Long-term acclimatization to moderate altitude may prevent the VO2max decline at a moderate altitude of 2,000 m particularly in subjects with lower VO2max levels, that is, below the 80th percentile (for age and sex). In people with higher fitness levels, VO2max may still be negatively affected. These results are of practical relevance, for e