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Deshayes TA, Sodabi DGA, Dubord M, Gagnon D. Shifting focus: Time to look beyond the classic physiological adaptations associated with human heat acclimation. Exp Physiol 2024; 109:335-349. [PMID: 37885125 PMCID: PMC10988689 DOI: 10.1113/ep091207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Planet Earth is warming at an unprecedented rate and our future is now assured to be shaped by the consequences of more frequent hot days and extreme heat. Humans will need to adapt both behaviorally and physiologically to thrive in a hotter climate. From a physiological perspective, countless studies have shown that human heat acclimation increases thermoeffector output (i.e., sweating and skin blood flow) and lowers cardiovascular strain (i.e., heart rate) during heat stress. However, the mechanisms mediating these adaptations remain understudied. Furthermore, several possible benefits of heat acclimation for other systems and functions involved in maintaining health and performance during heat stress remain to be elucidated. This review summarizes recent advances in human heat acclimation, with emphasis on recent studies that (1) advanced our understanding of the mechanisms mediating improved thermoeffector output and (2) investigated adaptations that go beyond those classically associated with heat acclimation. We highlight that these studies have contributed to a better understanding of the integrated physiological responses underlying human heat acclimation while leaving key unanswered questions that will need to be addressed in the future.
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Affiliation(s)
- Thomas A. Deshayes
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Dèwanou Gilles Arnaud Sodabi
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Marianne Dubord
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
| | - Daniel Gagnon
- Montreal Heart InstituteMontréalCanada
- School of Kinesiology and Exercise ScienceUniversité de MontréalMontréalCanada
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Eifling KP, Gaudio FG, Dumke C, Lipman GS, Otten EM, Martin AD, Grissom CK. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update. Wilderness Environ Med 2024; 35:112S-127S. [PMID: 38425235 DOI: 10.1177/10806032241227924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The Wilderness Medical Society (WMS) convened an expert panel in 2011 to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. The current panel retained 5 original members and welcomed 2 new members, all of whom collaborated remotely to provide an updated review of the classifications, pathophysiology, evidence-based guidelines for planning and preventive measures, and recommendations for field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. This is an updated version of the WMS clinical practice guidelines for the prevention and treatment of heat illness published in Wilderness & Environmental Medicine. 2019;30(4):S33-S46.
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Affiliation(s)
- Kurt P Eifling
- Department of Emergency Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR
| | - Flavio G Gaudio
- Department of Emergency Medicine, New York-Presbyterian Hospital / Weill Cornell Medical College, New York, NY
| | - Charles Dumke
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | | | - Edward M Otten
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH
| | - August D Martin
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR
| | - Colin K Grissom
- Pulmonary and Critical Care Division, Intermountain Medical Center and the University of Utah, Salt Lake City, UT
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Christison KS, Sol JA, Gurney SC, Dumke CL. Wildland Firefighter Critical Training Elicits Positive Adaptations to Markers of Cardiovascular and Metabolic Health. Wilderness Environ Med 2023; 34:328-333. [PMID: 37258395 DOI: 10.1016/j.wem.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The purpose of this study was to identify physiologic changes in body composition and resting metabolic markers of health across 2 wk of critical training (CT) in wildland firefighters (WLFFs). METHODS Twenty-two male and 3 female participants were recruited from 2 hotshot crews across the western United States prior to the 2022 fire season and monitored over their 80-h CT. Body weight (BW) and skinfolds were recorded before and after CT to estimate body fat (BF) and lean body weight (LBW). Blood was analyzed for changes in hematocrit, hemoglobin, plasma volume, and resting values of a lipid and metabolic panel. RESULTS The high physical demands of CT resulted in improvements in total cholesterol (-19.3 mg/dL, P<0.001), triglycerides (-34.4 mg/dL, P<0.001), low-density lipoprotein cholesterol (-18.1 mg/dL, P<0.001), very-low-density lipoprotein cholesterol (-5.2 mg/dL, P<0.001), high-density lipoprotein cholesterol (+4.0 mg/dL, P=0.002), non-high-density lipoprotein cholesterol (-19.3 mg/dL, P<0.001), and fasting glucose (-4.3 mg/dL, P=0.008) from before CT to after CT. Significant decreases in hemoglobin and hematocrit were also seen (P<0.001) with corresponding increases in estimated plasma volume (+6.1%, P<0.001). These alterations were seen despite maintenance of BW, LBW, and BF. Lower pretraining BF was associated with a greater magnitude of improvements in fasting glucose and cholesterol markers. CONCLUSIONS The observed improvements in baseline metabolic and cardiovascular markers along with plasma volume expansion suggest a positive response to the physical stress of WLFF CT. It appears that higher preseason fitness was associated with greater adaptations to the CT stressor.
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Affiliation(s)
- Katherine S Christison
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Joseph A Sol
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT; United States Department of Agriculture, Forest Service, National Technology and Development Program, Missoula, MT
| | - Shae C Gurney
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Charles L Dumke
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT.
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Matias AA, Albin IF, Glickman L, Califano PA, Faller JM, Layec G, Ives SJ. Impact of high intensity interval exercise with and without heat stress on cardiovascular and aerobic performance: a pilot study. BMC Sports Sci Med Rehabil 2023; 15:83. [PMID: 37434243 DOI: 10.1186/s13102-023-00682-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 06/21/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Heat stress during aerobic exercise training may offer an additional stimulus to improve cardiovascular function and performance in a cool-temperate environment. However, there is a paucity of information on the additive effects of high-intensity interval exercise (HIIE) and acute heat stress. We aimed to determine the effects of HIIE in combination with acute heat stress on cardiovascular function and exercise performance. METHODS Twelve active (peak O2 consumption [VO2peak]: 47 ± 8 ml·O2/min/kg) young adults were counterbalanced to six sessions of HIIE in hot (HIIE-H, 30 ± 1 °C, 50 ± 5% relative humidity [RH]) or temperate conditions (HIIE-T, 20 ± 2 °C, 15 ± 10% RH). Resting heart rate (HR), HR variability (HRV), central (cBP) and peripheral blood pressure (pBP), peripheral mean arterial pressure (pMAP), pulse wave velocity (PWV), VO2peak, and 5-km treadmill time-trial were measured pre- and post-training. RESULTS Resting HR and HRV were not significantly different between groups. However, expressed as percent change from baseline, cSBP (HIIE-T: + 0.9 ± 3.6 and HIIE-H: -6.6 ± 3.0%, p = 0.03) and pSBP (HIIE-T: -2.0 ± 4.6 and HIIE-H: -8.4 ± 4.7%, p = 0.04) were lower in the heat group. Post-training PWV was also significantly lower in the heat group (HIIE-T: + 0.4% and HIIE-H: -6.3%, p = 0.03). Time-trial performance improved with training when data from both groups were pooled, and estimated VO2peak was not significantly different between groups (HIIE-T: 0.7% and HIIE-H: 6.0%, p = 0.10, Cohen's d = 1.4). CONCLUSIONS The addition of acute heat stress to HIIE elicited additive adaptations in only cardiovascular function compared to HIIE alone in active young adults in temperate conditions, thus providing evidence for its effectiveness as a strategy to amplify exercise-induced cardiovascular adaptations.
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Affiliation(s)
- Alexs A Matias
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
- Department of Kinesiology, University of Massachusetts at Amherst, Amherst, MA, USA
| | - Isabelle F Albin
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Leah Glickman
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Peter A Califano
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Justin M Faller
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
| | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts at Amherst, Amherst, MA, USA
- Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - Stephen J Ives
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA.
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Effectiveness of short-term isothermic-heat acclimation (4 days) on physical performance in moderately trained males. PLoS One 2022; 17:e0270093. [DOI: 10.1371/journal.pone.0270093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 06/04/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
A typical heat acclimation (HA) protocol takes 5–7 d of 60–90 minutes of heat exposure. Identifying the minimum dose of HA required to elicit a heat adapted phenotype could reduce financial constraints on participants and aid in the tapering phase for competition in hot countries. Therefore, the aim of this study was to investigate a 4 d HA regimen on physical performance
Methods
Twelve moderately trained males were heat acclimated using controlled hyperthermia (Tre>38.5°C), with no fluid intake for 90 min on 4 consecutive days, with a heat stress test (HST) being completed one week prior to (HST2), and within one-week post (HST3) HA. Eleven completed the control study of HST1 versus HST2, one week apart with no intervention. Heat stress tests comprised of cycling for 90 min @ 40% Peak Power Output (PPO); 35°C; 60%RH followed by 10 minutes of passive recovery before an incremental test to exhaustion. Physical performance outcomes time to exhaustion (TTE), PPO, end rectal temperature (Tre END), and heart rate (HREND) was measured during the incremental test to exhaustion.
Results
Physiological markers indicated no significant changes in the heat; however descriptive statistics indicated mean resting Tre lowered 0.24°C (-0.54 to 0.07°C; d = 2.35: very large) and end-exercise lowered by 0.32°C (-0.81 to 0.16; d = 2.39: very large). There were significant improvements across multiple timepoints following HA in perceptual measures; Rate of perceived exertion (RPE), Thermal Sensation (TS), and Thermal Comfort (TC) (P<0.05). Mean TTE in the HST increased by 142 s (323±333 to 465±235s; P = 0.04) and mean PPO by 76W (137±128 to 213±77 W; P = 0.03).
Conclusion
Short-term isothermic HA (4 d) was effective in enhancing performance capacity in hot and humid conditions. Regardless of the level of physiological adaptations, behavioural adaptations were sufficient to elicit improved performance and thermotolerance in hot conditions. Additional exposures may be requisite to ensure physiological adaptation.
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Cognitive Performance Before and Following Habituation to Exercise-Induced Hypohydration of 2 and 4% Body Mass in Physically Active Individuals. Nutrients 2022; 14:nu14050935. [PMID: 35267911 PMCID: PMC8912814 DOI: 10.3390/nu14050935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 01/27/2023] Open
Abstract
We investigated the effect of repeated exposures to hypohydration upon cognitive performance. In a randomized crossover design, ten physically active adults completed two 4-week training blocks, one where they maintained euhydration (EUH) and the other where they were water-restricted (DEH) during walking/running at 55% V.O2max, 40 °C. Three sessions per week were performed: (1) 1 h of exercise, (2) exercise until 2% or (3) 4% of body mass has been lost or replaced. Limited to the first and fourth training week, a 12 min walking/running time-trial was completed following the 2 and 4% exercise bouts. Trail making, the Wisconsin card sort, the Stop signal task, Simple visual reaction time and Corsi block-tapping tests were performed immediately following the time-trials. Body mass loss was maintained < 1% with EUH and reached 2.7 and 4.7% with DEH following the time-trials. Except for a lower percentage of correct responses (% accuracy) during the Wisconsin card sort test (p < 0.05) with DEH compared to EUH, no statistically significant decline in cognitive performance was induced by low and moderate levels of hypohydration. Compared to week 1, no statistical differences in cognitive responses were observed after repeated exposures to hypohydration (all p > 0.05). From a practical perspective, the gains in cognitive performance following training to DEH were mostly unclear, but under certain circumstances, were greater than when EUH was maintained. Based on the battery of cognitive tests used in the current study, we conclude that whether physically active individuals are habituated or not to its effect, exercise-induced hypohydration of 2 and 4% has, in general, no or unclear impact on cognitive performance immediately following exercise. These results encourage further research in this area.
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Deshayes TA, Daigle N, Jeker D, Lamontagne-Lacasse M, Perreault-Briere M, Claveau P, Simoneau IL, Chamoux E, Goulet EDB. Impact of Repeated Acute Exposures to Low and Moderate Exercise-Induced Hypohydration on Physiological and Subjective Responses and Endurance Performance. Nutrients 2021; 13:nu13124477. [PMID: 34960028 PMCID: PMC8704556 DOI: 10.3390/nu13124477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine whether repeated exposures to low (2%) and moderate (4%) exercise-induced hypohydration may reverse the potentially deleterious effect of hypohydration on endurance performance. Using a randomized crossover protocol, ten volunteers (23 years, V˙O2max: 54 mL∙kg-1∙min-1) completed two 4-week training blocks interspersed by a 5-week washout period. During one block, participants replaced all fluid losses (EUH) while in the other they were fluid restricted (DEH). Participants completed three exercise sessions per week (walking/running, 55% V˙O2max, 40 °C): (1) 1 h while fluid restricted or drinking ad libitum, (2) until 2 and (3) 4% of body mass has been lost or replaced. During the first and the fourth week of each training block, participants completed a 12 min time-trial immediately after 2% and 4% body mass loss has been reached. Exercise duration and distance completed (14.1 ± 2.7 vs. 6.9 ± 1.5 km) during the fixed-intensity exercise bouts were greater in the 4 compared to the 2% condition (p < 0.01) with no difference between DEH and EUH. During the first week, heart rate, rectal temperature and perceived exertion were higher (p < 0.05) with DEH than EUH, and training did not change these outcomes. Exercise-induced hypohydration of 2% and 4% body mass impaired time-trial performance in a practical manner both at the start and end of the training block. In conclusion, exercise-induced hypohydration of 2% and 4% body mass impairs 12 min walking/running time-trial, and repeated exposures to these hypohydration levels cannot reverse the impairment in performance.
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Affiliation(s)
- Thomas A. Deshayes
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
| | - Nicolas Daigle
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
| | - David Jeker
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
| | - Martin Lamontagne-Lacasse
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
| | - Maxime Perreault-Briere
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
| | - Pascale Claveau
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
| | - Ivan L. Simoneau
- Centre de Recherche et de Formation par Simulation, Cegep of Sherbrooke, Sherbrooke, QC J1E 4K1, Canada;
| | - Estelle Chamoux
- Faculty of Arts and Science, Biological sciences, Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada;
| | - Eric D. B. Goulet
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (T.A.D.); (N.D.); (D.J.); (M.L.-L.); (M.P.-B.); (P.C.)
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Correspondence:
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Gurney SC, Christison KS, Williamson-Reisdorph CM, Sol JA, Quindry TS, Quindry JC, Dumke CL. Alterations in Metabolic and Cardiovascular Risk Factors During Critical Training in Wildland Firefighters. J Occup Environ Med 2021; 63:594-599. [PMID: 34184652 DOI: 10.1097/jom.0000000000002191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify physiologic stressors related to cardiovascular disease via changes in metabolic, inflammatory, and oxidative stress biomarkers during 2 weeks of preseason training in wildland firefighters (WLFFs). METHODS Participants were recruited from a local hotshot crew and monitored during preseason training. Fitness was assessed via the Bureau of Land Management fitness challenge. Venipuncture blood was collected on days 1, 4, 8, and 11 and analyzed for changes in a lipid and glucose panel, C-reactive protein, and oxidative stress markers 8-isoprostane (8ISO), 3-nitrotyrosine (3NT), lipid hydroperoxides (LOOH), and protein carbonyls. RESULTS The high physical demands of training resulted in significant (P < 0.05) reductions in total cholesterol, glucose, and hemoglobin A1c. A main effect for time was observed in 8ISO, 3NT, and LOOH. CONCLUSIONS Alterations in metabolic and oxidative stress markers suggest an acute, high-intensity physical stress during WLFF preseason training.
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Affiliation(s)
- Shae C Gurney
- School of Integrative Physiology and Athletic Training, University of Montana (Mr Gurney, Ms Christison, Mrs Williamson-Reisdorph, Mr Sol, Mrs Tiffany Quindry, Dr John Quindry, Dr Dumke); United States Department of Agriculture, Forest Service, National Technology and Development Program (Mr Sol), Missoula, Montana
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Knechtle B, McGrath C, Goncerz O, Villiger E, Nikolaidis PT, Marcin T, Sousa CV. The Role of Environmental Conditions on Master Marathon Running Performance in 1,280,557 Finishers the 'New York City Marathon' From 1970 to 2019. Front Physiol 2021; 12:665761. [PMID: 34079472 PMCID: PMC8165243 DOI: 10.3389/fphys.2021.665761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/14/2021] [Indexed: 01/29/2023] Open
Abstract
Aim: This study investigated the influence of weather conditions on running performance in female and male age group runners in the largest marathon in the world, the “New York City Marathon.” Methods: The analysis included data from 1,280,557 finishers the “New York City Marathon” from the years 1970 to 2019. Linear mixed models for men and women finishers with race time (min) as dependent variable and 5-year age groups, temperature, wind and relative humidity tertiles (low, medium, high) as independent factors and finisher as random intercept was performed. Additional models with an interaction between age groups and one weather variable each were performed. Results: Temperature was positively associated with race time while wind speed and humidity were negatively associated (p < 0.001). Men were significantly greater affected wind speed and humidity than women (p < 0.001 for interaction) but not by temperature (p = 0.17 for interaction). With an average of 8 min longer race time, high temperature had the greatest effect on race time. The effect of high humidity on race time was significantly increased in 40–59 years old men and 25–65 years old women. High temperatures had an increased effect on race time in 30–64 years old men and 40–64 years old women. The inverse association between race time and high wind speed was pronounced in finishers with younger age. Conclusion: Performance was lower on days with high temperature, low humidity and low wind speed. Men seemed to benefit more from higher humidity and wind speed than women. Aged (70 +) finishers were not greater affected by high temperatures.
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Affiliation(s)
- Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.,Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Carlyn McGrath
- Bouve College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Olivia Goncerz
- Bouve College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Elias Villiger
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | | | - Thimo Marcin
- Research Department, Berner Reha Zentrum, Bern, Switzerland
| | - Caio Victor Sousa
- Bouve College of Health Sciences, Northeastern University, Boston, MA, United States
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King MA, Rollo I, Baker LB. Nutritional considerations to counteract gastrointestinal permeability during exertional heat stress. J Appl Physiol (1985) 2021; 130:1754-1765. [PMID: 33955260 DOI: 10.1152/japplphysiol.00072.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Intestinal barrier integrity and function are compromised during exertional heat stress (EHS) potentially leading to consequences that range from minor gastrointestinal (GI) disturbances to fatal outcomes in exertional heat stroke or septic shock. This mini-review provides a concise discussion of nutritional interventions that may protect against intestinal permeability during EHS and suggests physiological mechanisms responsible for this protection. Although diverse nutritional interventions have been suggested to be protective against EHS-induced GI permeability, the ingestion of certain amino acids, carbohydrates, and fluid per se is potentially effective strategy, whereas evidence for various polyphenols and pre/probiotics is developing. Plausible physiological mechanisms of protection include increased blood flow, epithelial cell proliferation, upregulation of intracellular heat shock proteins, modulation of inflammatory signaling, alteration of the GI microbiota, and increased expression of tight junction (TJ) proteins. Further clinical research is needed to propose specific nutritional candidates and recommendations for their application to prevent intestinal barrier disruption and elucidate mechanisms during EHS.
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Affiliation(s)
- Michelle A King
- Gatorade Sports Science Institute, PepsiCo R&D Life Sciences, Barrington, Illinois
| | - Ian Rollo
- Gatorade Sports Science Institute, PepsiCo R&D Life Sciences, Leicestershire, United Kingdom
| | - Lindsay B Baker
- Gatorade Sports Science Institute, PepsiCo R&D Life Sciences, Barrington, Illinois
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Wardenaar FC, Ortega-Santos CP, Vento KAS, Beaumont JS, Griffin SC, Johnston C, Kavouras SA. A 5-day Heat Acclimation Program Improves Heat Stress Indicators While Maintaining Exercise Capacity. J Strength Cond Res 2021; 35:1279-1286. [PMID: 33900261 DOI: 10.1519/jsc.0000000000003970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Wardenaar, FC, Ortega-Santos, CP, Vento, K, Beaumont, JS, Griffin, SC, Johnston, C, and Kavouras, SA. A 5-day heat acclimation program improves heat stress indicators while maintaining exercise capacity. J Strength Cond Res 35(5): 1279-1286, 2021-This study aimed to evaluate whether a daily 60 minutes isothermic biking protocol during a 5-day period could improve physiological heat acclimation and exercise performance capacity in partially acclimated subjects. A quasi-experimental study consisted of an intervention (INT, n = 7) and control (CON, n = 7) group completing 2 12 minutes Cooper tests (pre-CT on day 1 and post-CT on day 7) and a heat stress test (HST, on day 9). INT performed additional intensive exercise 1 hour per day on days 1-5, whereas CON did not. During CTs and HST, core temperature (Tc, telemetric capsule), skin temperature (Tsk, sensors at neck, right shoulder, left hand, and right shin), and heart rate (HR, chest strap) were continuously monitored and baseline, average, peak, and increment were calculated. During the HST, the INT group showed a smaller baseline-peak Tc increment (INT 0.88 ± 0.27 vs. CON 1.64 ± 0.90° C, p = 0.02), a lower HR peak (150.2 ± 12.6 vs. 173.0 ± 16.8 b·min-1, p = 0.02), and lower Tsk peak (36.47 ± 0.62 vs. 36.54 ± 0.46° C, p = 0.04). There was a nonsignificant, but practical difference based on a moderate effect size for change in pre-CT to post-CT performance of nearly +2.7 ± 12.3% in INT and -3.0 ± 8.5% in CON (p = 0.32 and d = 0.51), and HST distance covered resulting in a nonsignificant difference of 464 ± 849 m between INT and CON (p = 0.38 and d = 0.44). In conclusion a short-term 5-day heat acclimation program including 300 minutes of extra exercise resulted in positive physiological adaptions to heat stress, as indicated by lower core temperature and HR in comparison with a control group.
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Affiliation(s)
- Floris C Wardenaar
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Carmen P Ortega-Santos
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Kaila A S Vento
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Joshua S Beaumont
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
- Sun Devil Athletics, Arizona State University, Tempe, Arizona
| | - Stephanie C Griffin
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona; and
| | - Carol Johnston
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Stavros A Kavouras
- Athleat Field Lab, College of Health Solutions, Arizona State University, Phoenix, Arizona
- College of Health Solutions, Arizona State University, Phoenix, Arizona
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Naito T, Haramura M, Muraishi K, Yamazaki M, Takahashi H. Cooling during short-term heat acclimation enhances aerobic capacity but not sweat capacity. Eur J Sport Sci 2021; 22:579-588. [PMID: 33522891 DOI: 10.1080/17461391.2021.1884751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To characterize the adaptive responses to short-term heat acclimation (HA) training with repeated-sprint exercises and to determine the effects of ice slurry ingestion during HA on aerobic capacity and adaptations. Seven physically active males completed two 5 consecutive day interventions in a randomized cross-over design. Participants performed approximately 80-min intermittent repeated-sprints using a cycling ergometer including break-time and half time in 36.5°C and 50%RH. Participants ingested either 1.25 g·kg body mass-1 of ice slurry (ICE: -1°C) or room temperature beverage (NOC: 36.5°C) throughout each break and 7.5 g·kg body mass-1 of the same drink during half time. Maximum oxygen uptake (V˙O2max) test in hot conditions was completed before and after HA training. Ice slurry ingestion during short-term HA training induced significantly higher both V˙O2max and watt at V˙O2max following HA training. Total work done was significantly higher in HA with ICE than for the NOC trial on both day 1 and day 5. Sweating Na+ concentration in NOC trial at day 5 were significantly lower than those in the NOC trial day 1, but was not observed in ICE trial. Cooling during HA training may be an effective strategy for enhancement of aerobic capacity via the adaptations gained from a higher quantity of exercise caused by cooling, but does not improve heat loss capacity. HighlightsThere is the potential dilemma whether cooling during short-term training in the heat might negatively impacts the process of helping athletes adapt to hot environments.Cooling during short-term heat training may be an effective strategy to enhancement of aerobic capacity via the adaptations gained from a higher quantity of exercise caused by cooling, but does not improve heat loss capacity.The study suggests the importance to selecting cooling during the heat acclimation phase of consecutive field training according to the individual's training plan.
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Affiliation(s)
- Takashi Naito
- Department of Sports Research, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Miki Haramura
- Department of Sports Sciences, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Koji Muraishi
- Japan Sport Council, Tokyo, Japan.,Graduate School of Community and Human Services, Rikkyo University, Saitama, Japan
| | - Misa Yamazaki
- Department of Sports Sciences, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Hideyuki Takahashi
- Department of Sports Research, Japan Institute of Sports Sciences, Tokyo, Japan.,Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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Greenfield AM, Pereira FG, Boyer WR, Apkarian MR, Kuennen MR, Gillum TL. Short-term hot water immersion results in substantial thermal strain and partial heat acclimation; comparisons with heat-exercise exposures. J Therm Biol 2021; 97:102898. [PMID: 33863451 DOI: 10.1016/j.jtherbio.2021.102898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/30/2021] [Accepted: 02/19/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine the effectiveness of hot water immersion (HWI) as a heat acclimation strategy in comparison to time and temperature matched, exercise-heat acclimation (EHA). METHODS 8 males performed heat stress tests (HST) (45 min of cycling at 50% of VO2max in 40 °C, 40% RH) before and after heat acclimation sessions. Acclimation sessions were either three consecutive bouts of HWI (40 min of submersion at 40 °C) or EHA (40 min of cycling at 50% VO2max in 40 °C, 40% RH). RESULTS Average change in tympanic temperature (TTympanic) was significantly higher following HWI (2.1 °C ± 0.4) compared to EHA (1.5 °C ± 0.4) (P < 0.05). Decreases in peak heart rate (HR) (HWI: -10 bpm ± 8; EHA: -6 ± 7), average HR (-7 bpm ± 6; -3 ± 4), and average core temperature (-0.4 °C ± 0.3; -0.2 ± 0.4) were evident following acclimation (P < 0.05), but not different between interventions (P > 0.05). Peak rate of perceived exertion (RPEPeak) decreased for HWI and EHA (P < 0.05). Peak thermal sensation (TSPeak) decreased following HWI (P < 0.05) but was not different between interventions (P > 0.05). Plasma volume increased in both intervention groups (HWI: 5.9% ± 5.1; EHA: 5.4% ± 3.7) but was not statistically different (P > 0.05). CONCLUSION HWI induced significantly greater thermal strain compared to EHA at equivalent temperatures during time-matched exposures. However, the greater degree of thermal strain did not result in between intervention differences for cardiovascular, thermoregulatory, or perceptual variables. Findings suggest three HWI sessions may be a potential means to lower HR, TCore, and perceptual strain during exercise in the heat.
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Affiliation(s)
- Andrew M Greenfield
- Department of Kinesiology, California Baptist University, 8432 Magnolia Ave, Riverside, CA, 92504, USA.
| | - Felipe Gorini Pereira
- Department of Kinesiology, California Baptist University, 8432 Magnolia Ave, Riverside, CA, 92504, USA.
| | - William R Boyer
- Department of Kinesiology, California Baptist University, 8432 Magnolia Ave, Riverside, CA, 92504, USA.
| | - Marc R Apkarian
- Department of Kinesiology and Health Science, Biola University, 13800 Biola Ave, La Mirada, CA, 90639, USA.
| | - Matthew R Kuennen
- Department of Exercise Science, High Point University, 1 N. University Parkway, High Point, NC, 27268, USA.
| | - Trevor L Gillum
- Department of Kinesiology, California Baptist University, 8432 Magnolia Ave, Riverside, CA, 92504, USA.
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Does Dehydration Affect the Adaptations of Plasma Volume, Heart Rate, Internal Body Temperature, and Sweat Rate During the Induction Phase of Heat Acclimation? J Sport Rehabil 2020; 29:847-850. [DOI: 10.1123/jsr.2019-0174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/25/2019] [Accepted: 11/13/2019] [Indexed: 11/18/2022]
Abstract
Clinical Scenario: Exercise in the heat can lead to performance decrements and increase the risk of heat illness. Heat acclimation refers to the systematic and gradual increase in exercise in a controlled, laboratory environment. Increased duration and intensity of exercise in the heat positively affects physiological responses, such as higher sweat rate, plasma volume expansion, decreased heart rate, and lower internal body temperature. Many heat acclimation studies have examined the hydration status of the subjects exercising in the heat. Some of the physiological responses that are desired to elicit heat acclimation (ie, higher heart rate and internal body temperature) are exacerbated in a dehydrated state. Thus, euhydration (optimal hydration) and dehydration trials during heat acclimation induction have been conducted to determine if there are additional benefits to dehydrated exercise trials on physiological adaptations. However, there is still much debate over hydration status and its effect on heat acclimation. Clinical Question: Does dehydration affect the adaptations of plasma volume, heart rate, internal body temperature, skin temperature, and sweat rate during the induction phase of heat acclimation? Summary of Findings: There were no observed differences in plasma volume, internal body temperature, and skin temperature following heat acclimation in this critically appraised topic. One study found an increase in sweat rate and another study indicated greater changes in heart rate following heat acclimation with dehydration. Aside from these findings, all 4 trials did not observe statistically significant differences in euhydrated and dehydrated heat acclimation trials. Clinical Bottom Line: There is minimal evidence to suggest that hydration status affects heat acclimation induction. In the studies that met the inclusion criteria, there were no differences in plasma volume concentrations, internal body temperature, and skin temperature. Strength of Recommendation: Based on the Oxford Centre for Evidence-Based Medicine Scale, Level 2 evidence exists.
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TRAVERS GAVIN, NICHOLS DAVID, RIDING NATHAN, GONZÁLEZ-ALONSO JOSÉ, PÉRIARD JULIEND. Heat Acclimation with Controlled Heart Rate: Influence of Hydration Status. Med Sci Sports Exerc 2020; 52:1815-1824. [DOI: 10.1249/mss.0000000000002320] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parsons IT, Stacey MJ, Woods DR. Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance. Front Physiol 2019; 10:1485. [PMID: 31920694 PMCID: PMC6928107 DOI: 10.3389/fphys.2019.01485] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/21/2019] [Indexed: 12/22/2022] Open
Abstract
The study of heat adaptation in military personnel offers generalizable insights into a variety of sporting, recreational and occupational populations. Conversely, certain characteristics of military employment have few parallels in civilian life, such as the imperative to achieve mission objectives during deployed operations, the opportunity to undergo training and selection for elite units or the requirement to fulfill essential duties under prolonged thermal stress. In such settings, achieving peak individual performance can be critical to organizational success. Short-notice deployment to a hot operational or training environment, exposure to high intensity exercise and undertaking ceremonial duties during extreme weather may challenge the ability to protect personnel from excessive thermal strain, especially where heat adaptation is incomplete. Graded and progressive acclimatization can reduce morbidity substantially and impact on mortality rates, yet individual variation in adaptation has the potential to undermine empirical approaches. Incapacity under heat stress can present the military with medical, occupational and logistic challenges requiring dynamic risk stratification during initial and subsequent heat stress. Using data from large studies of military personnel observing traditional and more contemporary acclimatization practices, this review article (1) characterizes the physical challenges that military training and deployed operations present (2) considers how heat adaptation has been used to augment military performance under thermal stress and (3) identifies potential solutions to optimize the risk-performance paradigm, including those with broader relevance to other populations exposed to heat stress.
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Affiliation(s)
- Iain T. Parsons
- Academic Department of Military Medicine, Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, United Kingdom
- School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Michael J. Stacey
- Academic Department of Military Medicine, Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, United Kingdom
- Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - David R. Woods
- Academic Department of Military Medicine, Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, United Kingdom
- Department of Sport and Exercise Endocrinology, Carnegie Research Institute, Leeds Beckett University, Leeds, United Kingdom
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Kissling LS, Akerman AP, Cotter JD. Heat-induced hypervolemia: Does the mode of acclimation matter and what are the implications for performance at Tokyo 2020? Temperature (Austin) 2019; 7:129-148. [PMID: 33015241 DOI: 10.1080/23328940.2019.1653736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Tokyo 2020 will likely be the most heat stressful Olympics to date, so preparation to mitigate the effects of humid heat will be essential for performance in several of the 33 sports. One key consideration is heat acclimation (HA); the repeated exposure to heat to elicit physiological and psychophysical adaptations that improve tolerance and exercise performance in the heat. Heat can be imposed in various ways, including exercise in the heat, hot water immersion, or passive exposure to hot air (e.g., sauna). The physical requirements of each sport will determine the impact that the heat has on performance, and the adaptations required from HA to mitigate these effects. This review focuses on one key adaptation, plasma volume expansion (PVE), and how the mode of HA may affect the kinetics of adaptation. PVE constitutes a primary HA-mediated adaptation and contributes to functional adaptations (e.g., lower heart rate and increased heat loss capacity), which may be particularly important in athletes of "sub-elite" cardiorespiratory fitness (e.g., team sports), alongside athletes of prolonged endurance events. This review: i) highlights the ability of exercise in the heat, hot-water immersion, and passive hot air to expand PV, providing the first quantitative assessment of the efficacy of different heating modes; ii) discusses how this may apply to athletes at Tokyo 2020; and iii) provides recommendations regarding the protocol of HA and the prospect for achieving PVE (and the related outcomes).
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Affiliation(s)
- Lorenz S Kissling
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ashley P Akerman
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.,Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - James D Cotter
- The School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
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