Inter-individual variation in the adaptive response to heat acclimation

Physiological response to exercise in the heat: Implications for risk mitigation and adaptation

Purpose

Recent field studies of physical exertion in challenging environmental conditions have reported dissociation between elevation in body core temperature (Tc) and successful task completion. This prompted us to further examine physiological mechanisms that might underlie variability in the response to exertional heat exposure. We hypothesized that, in response to exercise in the heat, systematic differences in central and peripheral physiological variables would be apparent between participants who successfully completed the task, versus those who became hyperthermic or symptomatic.

Methods

Thirty-eight healthy participants attempted a 120-min walk (5 km/h, 2% grade) in a climate-controlled chamber (40°C, 50%RH). At rest and at regular intervals during the walk, measures of physiological heat strain were assessed. Twenty-seven participants were Completers, seven were stopped because their Tc exceeded 39°C (Hyperthermics), and four became Symptomatic (e.g. lightheaded, headache, dizzy) and did not complete the walk.

Results

Visceral adipose tissue was higher in those who became Hyperthermic, compared to the Completers (437 ± 183 vs 245 ± 268 g; p = 0.034), despite similar height and body mass. Hyperthermics also had higher heart rate (p = 0.009), and lower end-diastolic volume (p = 0.031), and stroke volume (p = 0.031) during the early stages of walking, compared to the Completers. None of the Symptomatics reached a Tc >39°C (symptoms occurred at 38.1 ± 0.4°C), and none of the Hyperthermics reported symptoms.

Conclusions

During exertional heat exposure, adiposity and exaggerated early-stage hemodynamic responses were related to Tc elevation, but hyperthermia was not related to the development of symptoms, and baseline parameters relating to body composition and fitness were not related to symptom development.

Coping with extreme heat: current exposure and implications for the future

A preview of how effective behavioral, biological and technological responses might be in the future, when outdoor conditions will be at least 2°C hotter than current levels, is available today from studies of individuals already living in extreme heat. In areas where high temperatures are common-particularly those in the hot and humid tropics-several studies report that indoor temperatures in low-income housing can be significantly hotter than those outdoors. A case study indicates that daily indoor heat indexes in almost all the 123 slum dwellings monitored in Kolkata during the summer were above 41°C (106°F) for at least an hour. Economic constraints make it unlikely that technological fixes, such as air conditioners, will remedy conditions like these-now or in the future. People without access to air conditioning will have to rely on behavioral adjustments and/or biological/physiological acclimatization. One important unknown is whether individuals who have lived their entire lives in hot environments without air conditioning possess natural levels of acclimatization greater than those indicated by controlled laboratory studies. Answering questions about the future will require more studies of heat conditions experienced by individuals, more information on indoor versus outdoor heat conditions, and a greater understanding of the behavioral and biological adjustments made by people living today in extremely hot conditions.

The roles of ACE I/D and ACTN3 R577X gene variants in heat acclimation

Roles of genes in heat acclimation (HA, repeated exercise-heat exposures) had not been explored. ACE I/D and ACTN3 R577X genetic polymorphisms are closely associated with outstanding exercise performances. This study investigated whether the two polymorphisms influenced the response to HA. Fifty young Han nationality male subjects were selected and conducted HA for 2 weeks. Exercise indicators (5-km run, push-up and 100-m run) were tested and rest aural thermometry (RTau) was measured before and after HA. ACE gene was grouped by I homozygote and D carrier, and ACTN3 gene was grouped by R homozygote and X carrier. Results showed that there were no differences between groups in age, body mass index, exercise indicators and RTau before HA. After HA, RTau of ACE I homozygote was lower than that of D carrier [F (1, 48) = 9.12, p = 0.004, η = 0.40]. Compared with RTau before HA, that of I homozygote decreased after HA (Δ = -0.26 °C, 95 % CI -0.34-0.18, p < 0.001), while that of D carrier did not change. There was a ACE gene × HA interaction in RTau [F (1, 48) = 14.26, p < 0.001, η = 0.48]. No effect of ACTN3 gene on RTau was observed. For exercise indicators, there were no differences between groups after HA, and no gene × HA interactions were observed. There may be a strong interaction of ACE gene and HA in the change of rest core temperature. I homozygote may have an advantage on improving heat tolerance.

Effect of a 14-Day Period of Heat Acclimation on Horses Using Heated Indoor Arenas in Preparation for Tokyo Olympic Games

To optimise the performance and welfare of horses during equestrian competitions in hot climates, it is advised to acclimate them to the heat. The effects of training in a heated indoor arena were studied. Four Olympic horses (13.3 ± 2.2 years; three eventers, one para-dressage horse) were trained for 14 consecutive days in a heated indoor arena (32 ± 1 °C; 50-60% humidity) following their normal training schedule in preparation for the Tokyo Olympic games. Standardised exercise tests (SETs) were performed on Day 1 and Day 14, measuring heart rate (HR; bpm), plasma lactate concentration (LA; mmol/L), deep rectal temperature (Trec; °C), sweat loss (SL; L), and sweat composition (K+, Cl- and Na+ concentration). The data were analysed using linear mixed models. The Trec and HR were significantly decreased after acclimation (estimate: -0.106, 95% CI -0.134, -0.078; estimate: -4.067, 95% CI -7.535, -0.598, respectively). Furthermore, for all the horses, the time taken to reach their peak Trec and heat storage increased, while their LA concentrations decreased. The SL, Cl-, and Na+ concentrations decreased in three out of the four horses. Conclusions: Fourteen days of normal training in a heated indoor arena resulted in a reduction in cardiovascular and thermal strain. This is advantageous because it shows that elite sport horses can be acclimated while training as usual for a championship.

Occupational heat-related illness in Washington State: A descriptive study of day of illness and prior day ambient temperatures among cases and clusters, 2006-2021

BACKGROUND

Insufficient heat acclimatization is a risk factor for heat-related illness (HRI) morbidity, particularly during periods of sudden temperature increase. We sought to characterize heat exposure on days before, and days of, occupational HRIs.

METHODS

A total of 1241 Washington State workers' compensation State Fund HRI claims from 2006 to 2021 were linked with modeled parameter-elevation regressions on independent slopes model (PRISM) meteorological data. We determined location-specific maximum temperatures (Tmax,PRISM ) on the day of illness (DOI) and prior days, and whether the Tmax,PRISM was ≥10.0°F (~5.6°C) higher than the average of past 5 days ("sudden increase") for each HRI claim. Claims occurring on days with ≥10 HRI claims ("clusters") were compared with "non-cluster" claims using t tests and χ2 tests.

RESULTS

Seventy-six percent of analyzed HRI claims occurred on days with a Tmax,PRISM  ≥ 80°F. Claims occurring on "cluster" days, compared to "non-cluster" days, had both a significantly higher mean DOI Tmax,PRISM (99.3°F vs. 85.8°F [37.4°C vs. 29.9°C], t(148) = -18, p < 0.001) and a higher proportion of "sudden increase" claims (80.2% vs. 24.3%, χ2 [1] = 132.9, p < 0.001). Compared to "cluster" days, HRI claims occurring during the 2021 Pacific Northwest "heat dome" had a similar increased trajectory of mean Tmax,PRISM on the days before the DOI, but with higher mean Tmax,PRISM. CONCLUSIONS: Occupational HRI risk assessments should consider both current temperatures and changes in temperatures relative to prior days. Heat prevention programs should include provisions to address acclimatization and, when increases in temperature occur too quickly to allow for sufficient acclimatization, additional precautions.

Factors contributing to the change in thermoneutral maximal oxygen consumption after iso-intensity heat acclimation programmes

The factors explaining variance in thermoneutral maximal oxygen uptake (V˙O_2max) adaptation to heat acclimation (HA) were evaluated, with consideration of HA programme parameters, biophysical variables and thermo-physiological responses. Seventy-one participants consented to perform iso-intensity training (range: 45%-55% V˙O_2max) in the heat (range: 30°C-38°C; 20%-60% relative humidity) on consecutive days (range: 5-days-14-days) for between 50-min and-90 min. The participants were evaluated for their thermoneutral V˙O_2max change pre-to-post HA. Participants' whole-body sweat rate, heart rate, core temperature, perceived exertion and thermal sensation and plasma volume were measured, and changes in these responses across the programme determined. Partial least squares regression was used to explain variance in the change in V˙O_2max across the programme using 24 variables. Sixty-three percent of the participants increased V˙O_2max more than the test error, with a mean ± SD improvement of 2.6 ± 7.9%. A two-component model minimised the root mean squared error and explained the greatest variance (R²; 65%) in V˙O_2max change. Eight variables positively contributed (P < 0.05) to the model: exercise intensity (%V˙O_2max), ambient temperature, HA training days, total exposure time, baseline body mass, thermal sensation, whole-body mass losses and the number of days between the final day of HA and the post-testing day. Within the ranges evaluated, iso-intensity HA improved V˙O_2max 63% of the time, with intensity - and volume-based parameters, alongside sufficient delays in post-testing being important considerations for V˙O_2max maximisation. Monitoring of thermal sensation and body mass losses during the programme offers an accessible way to gauge the degree of potential adaptation.

A crossover control study of three methods of heat acclimation on the magnitude and kinetics of adaptation

NEW FINDINGS

Central question to the study? Are primary indices of heat adaptation (e.g., expansion of plasma volume and reduction in resting core temperature) differentially affected by the three major modes of short-term heat acclimation, i.e., exercise in the heat, hot water immersion and sauna? Main finding and its importance? The three modes elicited typical adaptations expected with short-term heat acclimation, however these were not significantly different between modes. This comparison has not previously been done and highlights that individuals can expect similar adaptation to heat regardless of the mode used.

ABSTRACT

Heat acclimation (HA) can improve heat tolerance and cardiovascular health. The mode of HA potentially impacts the magnitude and time course of adaptations, but almost no comparative data exist. We therefore investigated adaptive responses to three common modes of HA, particularly with respect to plasma volume. Within a crossover repeated-measures design, 13 physically-active participants (5 female) undertook four, 5-d HA regimes (60 min/d) in randomised order, separated by ≥4 wk. Rectal temperature (T_re ) was clamped at neutrality via 36.6C (thermoneutral) water immersion (TWI; i.e., control condition), or raised by 1.5°C via heat stress in 40°C water (HWI), Sauna (55°C, 52% RH), or exercise in humid heat (40°C, 52% RH; ExH). Adaptation magnitude was assessed as the pooled response across days 4 to 6, while kinetics was assessed via the 6-d time series. Plasma volume expansion was similar in all heated conditions but only higher than TWI in ExH (by 4%, p = 0.036). Approximately two thirds of the expansion was attained within the initial 24 h and was moderately related to that present on day 6, regardless of HA mode (r = 0.560-0.887). Expansion was mediated by conservation of both sodium and albumin content, with little evidence for these having differential roles between modes (p = 0.706 and 0.320, respectively). Resting T_re decreased by 0.1-0.3°C in all heated conditions, and SBP decreased by 4 mm Hg, but not differentially between conditions (p≥0.137). In conclusion, HA mode did not substantially affect the magnitude or rate of adaptation in key resting markers of short-term HA. This article is protected by copyright. All rights reserved.

Inter-Individual Variability of a High-Intensity Interval Training With Specific Techniques vs. Repeated Sprints Program in Sport-Related Fitness of Taekwondo Athletes

This study investigated the effect of 4 weeks of high-intensity interval training (HIIT) with specific techniques (TS-G) vs. repeated sprints (RS-G) and analyzed the inter-individual variability [classified into responders (Rs) and non-responders (NRs)] on sport-related fitness in taekwondo (TKD) athletes. Athletes of both genders (n = 12) were randomly assigned into TS-G and RS-G groups. Both groups trained 3 days/week for 4 weeks [two blocks of three rounds of 2 min of activity (4-s of all-out efforts with 28-s dynamical pauses) with 1 min of recovery in between and 5 min between blocks] during their regular training. The related sport fitness assessments included squat jump (SJ), countermovement jump (CMJ), multiple frequency speed of kick test (FSKT_MULT), specifically total kicks and Kick Decrement Index (KDI), and 20-m shuttle run (20MSR). Relevant results indicate a significant effect of the time factor in both groups for SJ performance and a significant decrease for KDI in RS-G. In addition, an improvement in performance according to the effect size analysis in the TS-G in total kicks, KDI, and 20MSR. Complementarily, a higher proportion of athlete Rs was reported in TS-G vs. RS-G for SJ (50% vs. 30.3%, respectively), CMJ, and total kicks (16.6% vs. 0%). In conclusion, the addition to the regular training of a HIIT with specific-techniques and repeated-sprints associated with intervals and similar structure of the combat during 4 weeks of training can improve the concentric characteristics of lower limb performance, although they were not the sufficient stimuli in the other components of TKD-related fitness.

Effects of High-Intensity Interval Training With Specific Techniques on Jumping Ability and Change of Direction Speed in Karate Athletes: An Inter-individual Analysis

This study investigated the effect of 4weeks of high-intensity interval training (HIIT) with specific techniques and analyzed inter-individual variability [classified in responders (Rs) and non-responders (NRs)] on jumping ability and change of direction speed (CODS) in youth karate athletes. Athletes of both genders (n=10) were randomly assigned into experimental group (EG; n=5) and the control group (CG; n=5). The EG trained 2-3days per week applying HIIT (three rounds [15 sets of 4s all-out specific efforts with 8s of dynamical pauses] with 3min of recovery between rounds) during their usual training during 4weeks. Assessments included squat jump (SJ) and countermovement jump (CMJ) and CODS by T-test. No significant interaction effect group by time was found. Although, in percentage and effect size (ES) terms increases were reported in both groups for SJ (EG: 15.2%, ES=0.91 vs. CG: 12.4%, ES=0.02) and only in EG for the T-test (-1.7%; ES=-0.35). In turn, a trend toward a higher proportion of Rs was observed in the EG (40% Rs) vs. CG (20% Rs) for SJ and CODS, respectively. In conclusion, the addition to regular training of a HIIT with specific techniques and based on the temporal combat structure after 4weeks was not a sufficient stimulus to increase jumping ability and CODS in karate athletes.

Factors Confounding the Athlete Biological Passport: A Systematic Narrative Review

BACKGROUND

Through longitudinal, individual and adaptive monitoring of blood biomarkers, the haematological module of the athlete biological passport (ABP) has become a valuable tool in anti-doping efforts. The composition of blood as a vector of oxygen in the human body varies in athletes with the influence of multiple intrinsic (genetic) or extrinsic (training or environmental conditions) factors. In this context, it is fundamental to establish a comprehensive understanding of the various causes that may affect blood variables and thereby alter a fair interpretation of ABP profiles.

METHODS

This literature review described the potential factors confounding the ABP to outline influencing factors altering haematological profiles acutely or chronically.

RESULTS

Our investigation confirmed that natural variations in ABP variables appear relatively small, likely-at least in part-because of strong human homeostasis. Furthermore, the significant effects on haematological variations of environmental conditions (e.g. exposure to heat or hypoxia) remain debatable. The current ABP paradigm seems rather robust in view of the existing literature that aims to delineate adaptive individual limits. Nevertheless, its objective sensitivity may be further improved.

CONCLUSIONS

This narrative review contributes to disentangling the numerous confounding factors of the ABP to gather the available scientific evidence and help interpret individual athlete profiles.

The Effect of Medium-Term Sauna-Based Heat Acclimation (MPHA) on Thermophysiological and Plasma Volume Responses to Exercise Performed under Temperate Conditions in Elite Cross-Country Skiers

The influence of a series of ten sauna baths (MPHA) on thermophysiological and selected hematological responses in 14 elite cross-country skiers to a submaximal endurance exercise test performed under thermoneutral environmental conditions was studied. Thermal and physiological variables were measured before and after the exercise test, whereas selected hematological indices were studied before, immediately after, and during recovery after a run, before (T1) and after sauna baths (T2). MPHA did not influence the baseline internal, body, and skin temperatures. There was a decrease in the resting heart rate (HR: p = 0.001) and physiological strain (PSI: p = 0.052) after MPHA and a significant effect of MPHA on systolic blood pressure (p = 0.03), hematological indices, and an exercise effect but no combined effect of treatments and exercise on the tested variables. A positive correlation was reported between PSI and total protein (%ΔTP) in T2 and a negative between plasma volume (%ΔPV) and mean red cellular volume (%ΔMCV) in T1 and T2 in response to exercise and a positive one during recovery. This may suggest that MPHA has a weak influence on body temperatures but causes a moderate decrease in PSI and modifications of plasma volume restoration in response to exercise under temperate conditions in elite athletes.

Roundtable on Preseason Heat Safety in Secondary School Athletics: Heat Acclimatization

OBJECTIVE

To provide best-practice recommendations for developing and implementing heat-acclimatization strategies in secondary school athletics.

DATA SOURCES

An extensive literature review on topics related to heat acclimatization and heat acclimation was conducted by a group of content experts. Using the Delphi method, action-oriented recommendations were developed.

CONCLUSIONS

A period of heat acclimatization consisting of ≥14 consecutive days should be implemented at the start of fall preseason training or practices for all secondary school athletes to mitigate the risk of exertional heat illness. The heat-acclimatization guidelines should outline specific actions for secondary school athletics personnel to use, including the duration of training, the number of training sessions permitted per day, and adequate rest periods in a cool environment. Further, these guidelines should include sport-specific and athlete-specific recommendations, such as phasing in protective equipment and reintroducing heat acclimatization after periods of inactivity. Heat-acclimatization guidelines should be clearly detailed in the secondary school's policy and procedures manual and disseminated to all stakeholders. Heat-acclimatization guidelines, when used in conjunction with current best practices surrounding the prevention, management, and care of secondary school student-athletes with exertional heat stroke, will optimize their health and safety.

Short-term heat acclimation preserves knee extensor torque but does not improve 20 km self-paced cycling performance in the heat

Purpose

This study investigated the effect of 5 days of heat acclimation training on neuromuscular function, intestinal damage, and 20 km cycling (20TT) performance in the heat.

Methods

Eight recreationally trained males completed two 5-day training blocks (cycling 60 min day⁻¹ at 50% peak power output) in a counter-balanced, cross-over design, with a 20TT completed before and after each block. Training was conducted in hot (HA: 34.9 ± 0.7 °C, 53 ± 4% relative humidity) or temperate (CON: 22.2 ± 2.6 °C, 65 ± 8% relative humidity) environment. All 20TTs were completed in the heat (35.1 ± 0.5 °C, 51 ± 4% relative humidity). Neuromuscular assessment of knee extensors (5 × 5 s maximum voluntary contraction; MVC) was completed before and after each 20TT and on the first and last days of each training block.

Results

MVC torque was statistically higher after 5 days of HA training compared to CON (mean difference = 14 N m [95% confidence interval; 6, 23]; p < 0.001; d = 0.77). However, 20TT performance after 5 days of HA training was not statistically different to CON, with a between-conditions mean difference in the completion time of 68 s [95% confidence interval; − 9, 145] (p = 0.076; d = 0.35).

Conclusion

Short-term heat acclimation training may increase knee extensor strength without changes in central fatigue or intestinal damage. Nevertheless, it is insufficient to improve 20 km self-paced cycling performance in the heat compared to workload-matched training in a temperate environment. These data suggest that recreationally trained athletes gain no worthwhile performance advantage from short-term heat-training before competing in the heat.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04744-y.

Individual characteristics associated with the magnitude of heat acclimation adaptations

PURPOSE

The magnitude of heat acclimation (HA) adaptations varies largely among individuals, but it remains unclear what factors influence this variability. This study compared individual characteristics related to fitness status and body dimensions of low-, medium-, and high responders to HA.

METHODS

Twenty-four participants (9 female, 15 male; maximum oxygen uptake [[Formula: see text]O2peak,kg] 52 ± 9 mL kg-1 min-1) completed 10 daily controlled-hyperthermia HA sessions. Adaptations were evaluated by heat stress tests (HST; 35 min cycling 1.5 W  kg-1; 33 °C, 65% relative humidity) pre- and post-HA. Low-, medium-, and high responder groups were determined based on tertiles (n = 8) of individual adaptations for resting rectal temperature (Tre), exercise-induced Tre rise (ΔTre), whole-body sweat rate (WBSR), and heart rate (HR).

RESULTS

Body dimensions (p > 0.3) and [Formula: see text]O2peak,kg (p > 0.052) did not differentiate low-, medium-, and high responders for resting Tre or ΔTre. High WBSR responders had a larger body mass and lower body surface area-to-mass ratio than low responders (83.0 ± 9.3 vs 67.5 ± 7.3 kg; 249 ± 12 vs 274 ± 15 cm2 kg-1, respectively; p < 0.005). Conversely, high HR responders had a smaller body mass than low responders (69.2 ± 6.8 vs 83.4 ± 9.4 kg; p = 0.02). [Formula: see text]O2peak,kg did not differ among levels of responsiveness for WBSR and HR (p > 0.3).

CONCLUSION

Individual body dimensions influenced the magnitude of sudomotor and cardiovascular adaptive responses, but did not differentiate Tre adaptations to HA. The influence of [Formula: see text]O2peak,kg on the magnitude of adaptations was limited.

Effects of Heat Acclimation and Acclimatisation on Maximal Aerobic Capacity Compared to Exercise Alone in Both Thermoneutral and Hot Environments: A Meta-Analysis and Meta-Regression

Background

Heat acclimation and acclimatisation (HA) is typically used to enhance tolerance to the heat, thereby improving performance. HA might also confer a positive adaptation to maximal oxygen consumption (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max), although this has been historically debated and requires clarification via meta-analysis.

Objectives

(1) To meta-analyse all studies (with and without control groups) that have investigated the effect of HA on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation in thermoneutral or hot environments; (2) Conduct meta-regressions to establish the moderating effect of selected variables on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation following HA.

Methods

A search was performed using various databases in May 2020. The studies were screened using search criteria for eligibility. Twenty-eight peer-reviewed articles were identified for inclusion across four separate meta-analyses: (1) Thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max within-participants (pre-to-post HA); (2) Hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max within-participants (pre-to-post HA); (3) Thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max measurement; HA vs. control groups; (4) Hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max measurement, HA vs. control groups. Meta-regressions were performed for each meta-analysis based on: isothermal vs. iso-intensity programmes, days of heat exposure, HA ambient temperature (°C), heat index, HA session duration (min), ambient thermal load (HA session x ambient temperature), mean mechanical intensity (W) and the post-HA testing period (days).

Results

The meta-analysis of pre–post differences in thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max demonstrated small-to-moderate improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max (Hedges’ g = 0.42, 95% CI 0.24–0.59, P < 0.001), whereas moderate improvements were found for the equivalent analysis of hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max changes (Hedges’ g = 0.63, 95% CI 0.26–1.00, P < 0.001), which were positively moderated by the number of days post-testing (P = 0.033, β = 0.172). Meta-analysis of control vs. HA thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max demonstrated a small improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max in HA compared to control (Hedges’ g = 0.30, 95% CI 0.06–0.54, P = 0.014) and this effect was larger for the equivalent hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max analysis where a higher (moderate-to-large) improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max was found (Hedges’ g = 0.75, 95% CI 0.22–1.27, P = 0.005), with the number of HA days (P = 0.018; β = 0.291) and the ambient temperature during HA (P = 0.003; β = 0.650) positively moderating this effect.

Conclusion

HA can enhance \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation in thermoneutral or hot environments, with or without control group consideration, by at least a small and up to a moderate–large amount, with the larger improvements occurring in the heat. Ambient heat, number of induction days and post-testing days can explain some of the changes in hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation.

Intensified Training Supersedes the Impact of Heat and/or Altitude for Increasing Performance in Elite Rugby Union Players

PURPOSE

To investigate whether including heat and altitude exposures during an elite team-sport training camp induces similar or greater performance benefits.

METHODS

The study assessed 56 elite male rugby players for maximal oxygen uptake, repeated-sprint cycling, and Yo-Yo intermittent recovery level 2 (Yo-Yo) before and after a 2-week training camp, which included 5 endurance and 5 repeated-sprint cycling sessions in addition to daily rugby training. Players were separated into 4 groups: (1) control (all sessions in temperate conditions at sea level), (2) heat training (endurance sessions in the heat), (3) altitude (repeated-sprint sessions and sleeping in hypoxia), and (4) combined heat and altitude (endurance in the heat, repeated sprints, and sleeping in hypoxia).

RESULTS

Training increased maximal oxygen uptake (4% [10%], P = .017), maximal aerobic power (9% [8%], P < .001), and repeated-sprint peak (5% [10%], P = .004) and average power (12% [14%], P < .001) independent of training conditions. Yo-Yo distance increased (16% [17%], P < .001) but not in the altitude group (P = .562). Training in heat lowered core temperature and increased sweat rate during a heat-response test (P < .05).

CONCLUSION

A 2-week intensified training camp improved maximal oxygen uptake, repeated-sprint ability, and aerobic performance in elite rugby players. Adding heat and/or altitude did not further enhance physical performance, and altitude appears to have been detrimental to improving Yo-Yo.

Aerobic but not thermoregulatory gains following a 10-day moderate-intensity training protocol are fitness level dependent: A cross-adaptation perspective

Moderate‐intensity exercise sessions are incorporated into heat‐acclimation and hypoxic‐training protocols to improve performance in hot and hypoxic environments, respectively. Consequently, a training effect might contribute to aerobic performance gains, at least in less fit participants. To explore the interaction between fitness level and a training stimulus commonly applied during acclimation protocols, we recruited 10 young males of a higher (more fit‐MF, peak aerobic power [VO_2peak]: 57.9 [6.2] ml·kg⁻¹·min⁻¹) and 10 of a lower (less fit‐LF, VO_2peak: 41.7 [5.0] ml·kg⁻¹·min⁻¹) fitness level. They underwent 10 daily exercise sessions (60 min@50% peak power output [W_peak]) in thermoneutral conditions. The participants performed exercise testing on a cycle ergometer before and after the training period in normoxic (NOR), hypoxic (13.5% F_iO₂; HYP), and hot (35°C, 50% RH; HE) conditions in a randomized and counterbalanced order. Each test consisted of two stages; a steady‐state exercise (30 min@40% NOR W_peak to evaluate thermoregulatory function) followed by incremental exercise to exhaustion. VO_2peak increased by 9.2 (8.5)% (p = .024) and 10.2 (15.4)% (p = .037) only in the LF group in NOR and HE, respectively. W_peak increases were correlated with baseline values in NOR (r = −.58, p = .010) and HYP (r = −.52, p = .018). MF individuals improved gross mechanical efficiency in HYP. Peak sweat rate increased in both groups in HE, whereas MF participants activated the forehead sweating response at lower rectal temperatures post‐training. In conclusion, an increase in VO_2peak but not mechanical efficiency seems probable in LF males after a 10‐day moderate‐exercise training protocol.

Methods for improving thermal tolerance in military personnel prior to deployment

Acute exposure to heat, such as that experienced by people arriving into a hotter or more humid environment, can compromise physical and cognitive performance as well as health. In military contexts heat stress is exacerbated by the combination of protective clothing, carried loads, and unique activity profiles, making them susceptible to heat illnesses. As the operational environment is dynamic and unpredictable, strategies to minimize the effects of heat should be planned and conducted prior to deployment. This review explores how heat acclimation (HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis, thereby improving performance and reducing heat illness risk. HA usually requires access to heat chamber facilities and takes weeks to conduct, which can often make it impractical and infeasible, especially if there are other training requirements and expectations. Recent research in athletic populations has produced protocols that are more feasible and accessible by reducing the time taken to induce adaptations, as well as exploring new methods such as passive HA. These protocols use shorter HA periods or minimise additional training requirements respectively, while still invoking key physiological adaptations, such as lowered core temperature, reduced heart rate and increased sweat rate at a given intensity. For deployments of special units at short notice (< 1 day) it might be optimal to use heat re-acclimation to maintain an elevated baseline of heat tolerance for long periods in anticipation of such an event. Methods practical for military groups are yet to be fully understood, therefore further investigation into the effectiveness of HA methods is required to establish the most effective and feasible approach to implement them within military groups.

Four-month operational heat acclimatization positively affects the level of heat tolerance 6 months later

Benefits obtained after heat acclimation/acclimatization should be completely lost after an estimated period of 6 weeks. However, this estimate is still hypothetical. We evaluate the long-term effects of heat acclimatization on the level of heat tolerance. Physiological and subjective markers of heat tolerance were assessed during a heat stress test (HST: 3 × 8-min runs outdoors [~ 40 °C and 20% RH] at 50% of their estimated speed at VO_2max) performed on the 2nd day upon arrival to the desert military base in the United Arab Emirates after a first day of mostly passive exposure to heat. Among the 50 male French soldiers, 25 partook in a 4-month military mission in countries characterized by a hot environment ~ 6 months prior to the study (HA). The other 25 participants were never heat acclimatized (CT). Rectal temperature (p = 0.023), heart rate (p = 0.033), and perceived exertion (p = 0.043) were lower in the HA than CT group at the end of HST. Soldiers who experienced a former 4-month period of natural heat acclimatization very likely had a higher level of heat tolerance during exercise in the heat, even 6 months after returning from the previous desert mission, than that of their non-acclimatized counterparts.

Sex differences in the physiological adaptations to heat acclimation: a state-of-the-art review

Over the last few decades, females have significantly increased their participation in athletic competitions and occupations (e.g. military, firefighters) in hot and thermally challenging environments. Heat acclimation, which involves repeated passive or active heat exposures that lead to physiological adaptations, is a tool commonly used to optimize performance in the heat. However, the scientific community's understanding of adaptations to heat acclimation are largely based on male data, complicating the generalizability to female populations. Though limited, current evidence suggests that females may require a greater number of heat acclimation sessions or greater thermal stress to achieve the same magnitude of physiological adaptations as males. The underlying mechanisms explaining the temporal sex differences in the physiological adaptations to heat acclimation are currently unclear. Therefore, the aims of this state-of-the-art review are to: (i) present a brief yet comprehensive synthesis of the current female and sex difference literature, (ii) highlight sex-dependent (e.g. anthropometric, menstrual cycle) and sex-independent factors (e.g. environmental conditions, fitness) influencing the physiological and performance adaptations to heat acclimation, and (iii) address key avenues for future research.

A basal heat stress test to detect military operational readiness after a 14-day operational heat acclimatization period

A basal heat stress test (HST) to predict the magnitude of adaptive responses during heat acclimatization (HA) would be highly useful for the armed forces. The aim was to identify physiological markers assessed during a HST (three 8-min running sets at 50% of the speed at VO_2max) performed just before a 14-day HA period that would identify participants still at "risk" at the end of HA. Individuals that responded poorly (large increases in rectal temperature [T_rec] and heart rate [HR]) during the initial HST were more likely to respond favorably to HA (large reductions in T_rec and HR). However, they were also more likely to exhibit lower tolerance to HST at D15. Basal T_rec was found to efficiently discriminate participants showing a T_rec > 38.5°C after HA, who are considered to be "at risk". Finally, participants were classified by quartiles based on basal T_rec and HR at the end of the HST and physiological strain index (PSI). Most of the participants "at risk" were among the upper quartile (i.e. the least tolerant) of T_rec and PSI (p = 0.011 for both). Overall, these results show that the individuals who are less tolerant to a basal HST are very likely to benefit the most from HA but they also remain less tolerant to heat at the end of HA than those who better tolerated the basal HST. A basal HST could therefore theoretically help the command to select the most-ready personnel in hot conditions while retaining those who are less tolerant 6.

Concurrent adaptations in maximal aerobic capacity, heat tolerance, microvascular blood flow and oxygen extraction following heat acclimation and ischemic preconditioning

We investigated the effects of: 1) Ischemic pre-conditioning (IPC) plus a concurrent five-day heat acclimation + IPC (IPC + HA), 2) five-day HA with sham IPC (HA), or 3) control (CON) on thermoneutral measurements of endurance performance, resting measures of skeletal muscle oxygenation and blood flow. Twenty-nine participants were randomly allocated to three groups, which included: 1) five-days of repeated leg occlusion (4 x 5-min) IPC at limb occlusive pressure, plus fixed-intensity (55% V˙ O_2max) cycling HA at ~36 °C/40% humidity; 2) HA plus sham IPC (20 mmHg) or 3) or CON (thermoneutral 55% V˙ O_2max plus sham IPC). In IPC + HA and HA, there were increases in maximal oxygen consumption (O_2max) (7.8% and 5.4%, respectively; P < 0.05), ventilatory threshold (V_T) (5.6% and 2.4%, respectively, P < 0.05), delta efficiency (DE) (2.0% and 1.4%, respectively; P < 0.05) and maximum oxygen pulse (O₂pulse-Max) (7.0% and 6.9%, respectively; P < 0.05) during an exhaustive incremental test. There were no changes for CON (P > 0.05). Changes (P < 0.05) in resting core temperature (T_C), muscle oxygen consumption (m V˙ O₂), and limb blood flow (LBF) were also found pre-to-post intervention among the HA and IPC + HA groups, but not in CON (P > 0.05). Five-days of either HA or IPC + HA can enhance markers of endurance performance in cooler environments, alongside improved muscle oxygen extraction, blood flow, exercising muscle efficiency and O₂ pulse at higher intensities, thus suggesting the occurrence of peripheral adaptation. Both HA and IPC + HA enhance the adaptation of endurance capacity, which might partly relate to peripheral changes.

Effects of Pre-Cooling on Thermophysiological Responses in Elite Eventing Horses

Simple Summary

Horses have a high metabolic capacity for exercise, producing a great deal of heat, and have a small surface area for heat loss. Under limited circumstances, the regulation of heat loss (i.e., across the respiratory tract and by the evaporation of sweat) means heat build-up in the body is reduced. Thermoregulation can be assisted by cooling the horses down to safely perform exercise in thermally challenging environments. The present study showed that pre-cooling (i.e., cooling between the warm-up and exercise performance) slightly reduced the rise in rectal, shoulder and rump skin temperatures of ten international eventing horses during moderately intense canter training in moderate environmental conditions. During the canter training, heart rate, sweat rate and sweat composition were unaffected by pre-cooling. The pre-cooling strategy chosen here was cold-water rinsing for a short period of time (~8 min). Considering the limited time and space at equestrian events, such a pre-cooling strategy could easily be implemented. Reducing heat strain by pre-cooling may potentially improve equine welfare during events.

Abstract

In this study, we examined the effects of pre-cooling on thermophysiological responses in horses exercising in moderate environmental conditions (average wet bulb globe temperature: 18.5 ± 3.8 °C). Ten international eventing horses performed moderate intensity canter training on two separate days, and were either pre-cooled with cold-water rinsing (5–9 °C for 8 ± 3 min; cooling) or were not pre-cooled (control). We determined velocity (V), heart rate (HR), rectal temperature (T_re,), shoulder and rump skin temperature (T_shoulder and T_rump), plasma lactate concentration (LA), gross sweat loss (GSL), and local sweat rate (LSR), as well as sweat sodium, chloride and potassium concentrations. The effect of pre-cooling on T_re was dependent on time; after 20 min of exercise the effect was the largest (estimate: 0.990, 95% likelihood confidence intervals (95% CI): 0.987, 0.993) compared to the control condition, resulting in a lower median T_re of 0.3 °C. Skin temperature was also affected by pre-cooling compared to the control condition (T_shoulder: −3.30 °C, 95% CI: −3.739, −2.867; T_rump: −2.31 °C, 95% CI: −2.661, −1.967). V, HR, LA, GSL, LSR and sweat composition were not affected by pre-cooling. In conclusion, pre-cooling by cold-water rinsing could increase the margin for heat storage, allowing a longer exercise time before a critical T_re is reached and, therefore, could potentially improve equine welfare during competition.

A retrospective analysis to determine if exercise training-induced thermoregulatory adaptations are mediated by increased fitness or heat acclimation

NEW FINDINGS

What is the central question of this study? Are fitness-related improvements in thermoregulatory responses during uncompensable heat stress mediated by aerobic capacity V ̇ O 2 max or is it the partial heat acclimation associated with training? What is the main finding and its importance? During uncompensable heat stress, individuals with high and low V ̇ O 2 max displayed similar sweating and core temperature responses whereas exercise training in previously untrained individuals resulted in a greater sweat rate and a smaller rise in core temperature. These observations suggest that it is training, not V ̇ O 2 max per se, that mediates thermoregulatory improvements during uncompensable heat stress.

ABSTRACT

It remains unclear whether aerobic fitness, as defined by the maximum rate of oxygen consumption V ̇ O 2 max , independently improves heat dissipation in uncompensable environments, or whether the thermoregulatory adaptations associated with heat acclimation are due to repeated bouts of exercise-induced heat stress during regular aerobic training. The present analysis sought to determine if V ̇ O 2 max independently influences thermoregulatory sweating, maximum skin wettedness (ω_max ) and the change in rectal temperature (ΔT_re ) during 60 min of exercise in an uncompensable environment (37.0 ± 0.8°C, 4.0 ± 0.2 kPa, 64 ± 3% relative humidity) at a fixed rate of heat production per unit mass (6 W kg^-1 ). Retrospective analyses were performed on 22 participants (3 groups), aerobically unfit (UF; n = 7; V ̇ O 2 max : 41.7 ± 9.4 ml kg^-1  min^-1 ), aerobically fit (F; n = 7; V ̇ O 2 max : 55.6 ± 4.3 ml kg^-1  min^-1 ; P < 0.01) and aerobically unfit (n = 8) individuals, before (pre; V ̇ O 2 max : 45.8 ± 11.6 ml kg^-1  min^-1 ) and after (post; V ̇ O 2 max : 52.0 ± 11.1 ml kg^-1  min^-1 ; P < 0.001) an 8-week training intervention. ω_max was similar between UF (0.74 ± 0.09) and F (0.78 ± 0.08, P = 0.22). However, ω_max was greater post- (0.84 ± 0.08) compared to pre- (0.72 ± 0.06, P = 0.02) training. During exercise, mean local sweat rate (forearm and upper-back) was greater post- (1.24 ± 0.20 mg cm^-2  min^-1 ) compared to pre- (1.04 ± 0.25 mg cm^-2  min^-1 , P < 0.01) training, but similar between UF (0.94 ± 0.31 mg cm^-2  min^-1 , P = 0.90) and F (1.02 ± 0.30 mg cm^-2  min^-1 ). The ΔT_re at 60 min of exercise was greater pre- (1.13 ± 0.16°C, P < 0.01) compared to post- (0.96 ± 0.14°C) training, but similar between UF (0.85 ± 0.29°C, P = 0.22) and F (0.95 ± 0.22°C). Taken together, aerobic training, not V ̇ O 2 max per se, confers an increased ω_max , greater sweat rate, and smaller rise in core temperature during uncompensable heat stress in fit individuals.

Heat alleviation strategies for athletic performance: A review and practitioner guidelines

International competition inevitably presents logistical challenges for athletes. Events such as the Tokyo 2020 Olympic Games require further consideration given historical climate data suggest athletes will experience significant heat stress. Given the expected climate, athletes face major challenges to health and performance. With this in mind, heat alleviation strategies should be a fundamental consideration. This review provides a focused perspective of the relevant literature describing how practitioners can structure male and female athlete preparations for performance in hot, humid conditions. Whilst scientific literature commonly describes experimental work, with a primary focus on maximizing magnitudes of adaptive responses, this may sacrifice ecological validity, particularly for athletes whom must balance logistical considerations aligned with integrating environmental preparation around training, tapering and travel plans. Additionally, opportunities for sophisticated interventions may not be possible in the constrained environment of the athlete village or event arenas. This review therefore takes knowledge gained from robust experimental work, interprets it and provides direction on how practitioners/coaches can optimize their athletes' heat alleviation strategies. This review identifies two distinct heat alleviation themes that should be considered to form an individualized strategy for the athlete to enhance thermoregulatory/performance physiology. First, chronic heat alleviation techniques are outlined, these describe interventions such as heat acclimation, which are implemented pre, during and post-training to prepare for the increased heat stress. Second, acute heat alleviation techniques that are implemented immediately prior to, and sometimes during the event are discussed. Abbreviations: CWI: Cold water immersion; HA: Heat acclimation; HR: Heart rate; HSP: Heat shock protein; HWI: Hot water immersion; LTHA: Long-term heat acclimation; MTHA: Medium-term heat acclimation; ODHA: Once-daily heat acclimation; RH: Relative humidity; RPE: Rating of perceived exertion; STHA: Short-term heat acclimation; TCORE: Core temperature; TDHA: Twice-daily heat acclimation; TS: Thermal sensation; TSKIN: Skin temperature; V̇O2max: Maximal oxygen uptake; WGBT: Wet bulb globe temperature.

The time course of adaptations in thermoneutral maximal oxygen consumption following heat acclimation

PURPOSE

This study investigated the effects of a 10-day heat acclimation (HA) programme on the time course of changes in thermoneutral maximal oxygen uptake ([Formula: see text]O_2max) during and up to 10 days post-HA.

METHODS

Twenty-two male cyclists were assigned to a HA or control (Con) training group following baseline ramp tests of thermoneutral [Formula: see text]O_2max. Ten days of fixed-intensity (50% baseline [Formula: see text]O_2max) indoor cycling was performed in either ~ 38.0 °C (HA) or ~ 20 °C (Con). [Formula: see text]O_2max was re-tested on HA days 5, 10 and post-HA days 1, 2, 3, 4, 5 and 10.

RESULTS

[Formula: see text]O_2max initially declined across time in both groups during training (P < 0.05), before increasing in the post-HA period in both groups (P < 0.05). However, [Formula: see text]O_2max was higher than control by post-HA day 4 in the HA group (P = 0.046).

CONCLUSIONS

The non-linear time course of [Formula: see text]O_2max adaptation suggests that post-testing should be performed 96-h post-training to identify the maximal change for most individuals. In preparation for training or testing, athletes can augment their aerobic power in thermoneutral environments by performing 10 days HA, but the full effects will manifest at varying stages of the post-HA period.

Passive Heating: Reviewing Practical Heat Acclimation Strategies for Endurance Athletes

Heat acclimation protocols—both active and passive—have been employed by athletes in an effort to attenuate the detrimental effects of heat stress on physical capacities and sports performance. Active strategies have been extensively reviewed, but have various practical and economic limitations. The purpose of this review was therefore to provide an overview of the passive strategies that have received less attention, yet may be more practical or economically viable; recommendations for athletes are also provided. With a systematic search of the relevant databases ending in June 2018, 16 articles on passive heat acclimation that met the inclusion criteria were included in the review. The review highlighted that passive heat acclimation strategies can successfully induce heat adaptations, evident by reports of improved exercise performance, thermoregulatory, cardiovascular, and perceptual responses accompanying such interventions. Based on the review it is apparent that the use of sauna, hot-water immersion and environmental chambers may be used to provide heat stress under passive conditions, for the purpose of acclimation. To maximize the thermoregulatory-adaptive responses, exercise bouts should be employed prior to passive heat stress, rather than passive heating alone, with a minimal delay between exercise and the application of heat stress. Heating bouts should have a minimum duration of 30 min per session and be employed on consecutive days, when possible, with a minimum of 6–7 exposures to induce adaptation. This review identified that information regarding the magnitude of performance changes that can occur, as well as the perceptual responses to passive heating protocols is limited. Future research should investigate the use of passive heat exposures before and/or after repeated heat training sessions, to assess if a further boost to heat adaptation can be achieved with this strategy.

Once- and twice-daily heat acclimation confer similar heat adaptations, inflammatory responses and exercise tolerance improvements

This experiment aimed to investigate the efficacy of twice-daily, nonconsecutive heat acclimation (TDHA) in comparison to once-daily heat acclimation (ODHA) and work matched once- or twice-daily temperate exercise (ODTEMP, TDTEMP) for inducing heat adaptations, improved exercise tolerance, and cytokine (immune) responses. Forty males, matched biophysically and for aerobic capacity, were assigned to ODHA, TDHA, ODTEMP, or TDTEMP. Participants completed a cycling-graded exercise test, heat acclimation state test, and a time to task failure (TTTF) at 80% peak power output in temperate (TTTFTEMP : 22°C/40% RH) and hot conditions (TTTFHOT : 38°C/20% RH), before and after 10-sessions (60 min of cycling at ~2 W·kg-1 ) in 45°C/20% RH (ODHA and TDHA) or 22°C/40% RH (ODTEMP or TDTEMP). Plasma IL-6, TNF-α, and cortisol were measured pre- and postsessions 1, 5, and 10. ODHA and TDHA induced equivalent heat adaptations (P < 0.05) (resting rectal temperature [-0.28 ± 0.22, -0.28 ± 0.19°C], heart rate [-10 ± 3, -10 ± 4 b·min-1 ], and plasma volume expansion [+10.1 ± 5.6, +8.5 ± 3.1%]) and improved heat acclimation state (sweat set point [-0.22 ± 0.18, -0.22 ± 0.14°C] and gain [+0.14 ± 0.10, +0.15 ± 0.07 g·sec-1 ·°C-1 ]). TTTFHOT increased (P < 0.001) following ODHA (+25 ± 4%) and TDHA (+24 ± 10%), but not ODTEMP (+5 ± 14%) or TDTEMP (+5 ± 17%). TTTFTEMP did not improve (P > 0.05) following ODHA (+14 ± 4%), TDHA (14 ± 8%), ODTEMP (9 ± 10%) or TDTEMP (8 ± 13%). Acute (P < 0.05) but no chronic (P > 0.05) increases were observed in IL-6, TNF-α, or cortisol during ODHA and TDHA, or ODTEMP and TDTEMP. Once- and twice-daily heat acclimation conferred similar magnitudes of heat adaptation and exercise tolerance improvements, without differentially altering immune function, thus nonconsecutive TDHA provides an effective, logistically flexible method of HA, benefitting individuals preparing for exercise-heat stress.

Thermoregulatory burden of elite sailing athletes during exercise in the heat: A pilot study

Exercising in a hot and humid environment increases core body temperature, which may limit exercise performance. The risk of exercise-induced hyperthermia and associated performance decrement in Olympic sailing athletes is largely unknown. Therefore, this study aimed to compare thermoregulatory responses and performance indicators of elite sailors in a cool versus hot and humid environment. Seven elite athletes from four different Olympic sailing classes (Laser, RS:X, Finn, 470) performed cycling and/or rowing exercise in a cool (18°C) and hot (33°C) environment, while core body temperature (T_C), skin temperature (T_SK), exercise performance (covered distance), and rating of perceived exertion were measured continuously. T_C increased significantly more in the hot environment (37.6 ± 0.2°C to 39.1 ± 0.1°C) compared to the cool environment (37.5 ± 0.1°C to 38.5 ± 0.2°C; p = 0.002), but the increase in T_C between conditions differed substantially within individuals (range: 0.3°C – 0.9°C). Exercise performance decreased by 6.2 ± 2.9% in the hot environment (p = 0.013, range: 2.3%–9.5%), but more importantly, exercise performance was strongly inversely related to peak T_C (R = −0.78, p = 0.039). Rating of perceived exertion (cool: 14.2 ± 0.6; hot: 13.9 ± 1.2) and increase in T_SK (cool: 0.5 ± 1.0°C; hot: 0.9 ± 0.3°C) did not differ between conditions (p = 0.59 and p = 0.36, respectively). To conclude, a larger increase in T_C and substantial exercise performance decrement were observed in the hot versus cool environment. As a further matter, large inter-individual differences were observed across athletes with an inverse relationship between T_C and exercise performance, which stresses the importance of appropriate and personalized interventions to reduce thermoregulatory burden of elite sailors during exercise in the heat.

Application of evidence-based recommendations for heat acclimation: Individual and team sport perspectives

Heat acclimation or acclimatization (HA) occurs with repeated exposure to heat inducing adaptations that enhance thermoregulatory mechanisms and heat tolerance leading to improved exercise performance in warm-to-hot conditions. HA is an essential heat safety and performance enhancement strategy in preparation for competitions in warm-to-hot conditions for both individual and team sports. Yet, some data indicate HA is an underutilized pre-competition intervention in athletes despite the well-known benefits; possibly due to a lack of practical information provided to athletes and coaches. Therefore, the aim of this review is to provide actionable evidence-based implementation strategies and protocols to induce and sustain HA. We propose the following suggestions to circumvent potential implementation barriers: 1) incorporate multiple induction methods during the initial acclimation period, 2) complete HA 1-3 weeks before competition in the heat to avoid training and logistical conflicts during the taper period, and 3) minimize adaptation decay through intermittent exercise-heat exposure or re-acclimating immediately prior to competition with 2-4 consecutive days of exercise-heat training. Use of these strategies may be desirable or necessary to optimize HA induction and retention around existing training or logistical requirements.