Ice slurry ingestion reduces human brain temperature measured using non-invasive magnetic resonance spectroscopy

Ad libitum ice slurry ingestion and half-marathon performance in a hot environment: A study comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C

Ice slurry ingestion during prolonged exercises may improve performance in hot environments; however, the ideal amount and timing of ingestion are still uncertain. We determined whether ad libitum ice slurry ingestion influences physiological and perceptual variables and half-marathon performance while comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C. Ten trained participants (28 ± 2 years; mean and SD) were required to run two half marathons while consuming either ice slurry (-1 °C; Ad-1) or water (37 °C; 37 CE) ad libitum. They then performed two other half marathons where, during one, they were required to ingest an amount of water equivalent to the amount consumed during the Ad-1 trial (Pro37), and in the other, to ingest ice slurry in the amount consumed during the 37 CE trial (Pro-1). During the half marathons, dry-bulb temperature and relative humidity were controlled at 33.1 ± 0.3 °C and 60 ± 3%, respectively. Ad-1 ingestion (349.6 ± 58.5 g) was 45% less than 37 CE ingestion (635.5 ± 135.8 g). Physical performance, heart rate, perceived exertion, body temperatures, and thermal perception were not influenced by the temperature or amount of beverage ingestion. However, a secondary analysis suggested that lower beverage ingestion was associated with improved performance (Ad-1 + Pro37 vs. 37 CE + Pro-1: -4.0 min, Cohen's d = 0.39), with a significant relationship between lower beverage ingestion and faster running time (b = 0.02, t = 4.01, p < 0.001). In conclusion, ice slurry ingestion does not affect performance or physiological or perceptual variables during a half marathon in a hot environment. Preliminary evidence suggests that lower beverage ingestion (ice slurry or warm water) is associated with improved performance compared to higher ingestion.

Small Performance Effects of a Practical Mixed-Methods Cooling Strategy in Elite Team Sport Athletes

Purpose: The ingestion of ice slurry and application of ice towels can elicit favorable physiological, perceptual, and performance benefits when used individually; however, the combined use and effectiveness of these practical cooling strategies have not been assessed using a sport-specific performance test, based on actual match demands, in an elite team sport context. Methods: Ten non-heat acclimated elite male rugby sevens athletes undertook two cycling heat response tests (HRT) designed to be specific to the demands of rugby sevens in hot conditions (35°C, 80% rH). In a crossover design, the HRTs were conducted with (COOLING) and without (HOT) the combined use of internal (ice slushy ingestion) and external (application of ice towels to the head, neck, and face) pre- and per-cooling strategies. Physiological, perceptual, and performance variables were monitored throughout each HRT. Results: COOLING resulted in reductions in mean tympanic temperature (-0.4 ± 0.2°C; d = 1.18); mean heart rate (-5 ± 8 bpm; d = 0.53); thermal discomfort (-0.5 ± 0.9 AU; d = 0.48); and thirst sensation (-1.0 ± 1.1 AU; d = 0.61) during the HRT. COOLING also resulted in a small increase in 4-min time trial power output (by 7 ± 33 W, ~3%; d = 0.35) compared to HOT. Discussion: A combination of internal and external pre- and per-cooling strategies can result in a range of small physiological, perceptual, and performance benefits during a rugby sevens specific HRT, compared to undertaking no cooling. Practitioners should include such strategies when performing in hot conditions.

Effect of electric fan use in isolation or combined with ice slurry/cold water ingestion and lower-leg immersion in young men during intermittent physical activity in hot-humid conditions

Using a randomized crossover protocol, 10 young men completed four 180 min exposures (38 °C, 60% relative humidity), alternating between 30 min of walking and 30 min of sitting where fluid or ice slurry were served. Participants underwent four trials: (i) 5 mL·kg body mass-1 of 20 °C water (CON); (ii) 5 mL·kg body mass-1 of 20 °C water + fan at 4 m·s-1 (FAN); (iii) fan + 3 mL·kg body mass-1 of ice slurry + 2 mL·kg body mass-1 of 4 °C water (FAN + ISCW); and (iv) FAN + ISCW + lower-leg immersion in 20 °C water (FAN + ISCW + LLI). Sweat and body mass losses were higher with FAN than CON, FAN + ISCW, and FAN + ISCW + LLI. Mean and peak changes in Δrectal temperature, heart rate, and perceived heat and thirst from baseline were not statistically and practically different between FAN and CON. FAN + ISCW + LLI decreased sweat loss compared with FAN + ISCW and mean and peak changes in Δrectal temperature, heart rate, and perceived thirst compared with CON. FAN + ISCW + LLI also attenuated the changes in Δrectal temperature (peak) and thirst (mean and peak) compared with FAN. In conclusion, FAN slightly exacerbates fluid loss but does not attenuate the changes in Δrectal temperature, heart rate, and perceived heat and thirst during intermittent physical activity in hot-humid conditions. However, coupling ISCW or ISCW + LLI with the use of a fan attenuates the increase in these outcomes compared with no intervention and to a greater extent for rectal temperature and thirst when fan is coupled with ISCW + LLI than when it is used in isolation.

The Effects of Pre-Exercise Ice-Slurry Ingestion on Thermoregulation and Exercise Performance of Highly Trained Athletes: A Scoping Review

Ice-slurry prepared from plain ice, crushed ice, or sports drink has been used as a cooling strategy before exercise to regulate body temperature and improve exercise performance. However, consensus regarding the benefit is unclear. Therefore, the present review aimed to study the effects of pre-exercise ice-slurry ingestion on thermoregulation and exercise performance of highly trained athletes. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used. The data extraction was done using the search engine Google Scholar, and digital repositories such as Cochrane, Scopus, Medline, Ebsco, Proquest and Pubmed. The keywords 'Pre-cooling', 'Ice-slurry', 'Ice Slush' 'Thermoregulation' 'Heat Loss' 'Heat Stress' 'Body Temperature' 'Athletes', 'Sports Persons' 'Exercise Performance' were used. Among the identified records (n = 151), 11 articles which met the inclusion criteria were examined. Out of the eleven studies, six studies reported a significant decrease in core/rectal/GI/skin/body temperature, and six studies reported a significant increase, or positive influence on exercise performance, and three studies both on thermoregulation and exercise performance. Ingestion of pre-exercise ice-slurry (30 min BE; -1°C to +1°C) in the dosage range of 7-14g/kg/BM has a significant beneficial effect on thermoregulation and exercise performance. Ice-slurry prepared from plain crushed ice, or sports drink, or carbohydrate and electrolyte drinks may have a similar effect on thermoregulation and exercise performance.

Effect of ice slurry ingestion on thermoregulatory responses during fixed-intensity cycling in humid and dry heat

PURPOSE

This study examined the thermoregulatory response and ergogenic effects of ice slurry (ICE) ingestion in hot environments with high and low relative humidity (RH).

METHODS

Eight males completed four trials in a crossover manner in dry (DRY: 34.7 ± 0.2 °C, 38 ± 2%RH) and humid heat (HUM: 34.8 °C ± 0.2 °C, 80 ± 1%RH). They ingested 8.0 g·kg-1 of ICE (0.0 °C) or 37.5 °C water (CON) during 30 min before exercise, and three aliquots (3.2 g·kg-1) of ICE or CON during 45-min cycling at 50%[Formula: see text]O2peak, followed by cycling to exhaustion at 80%[Formula: see text]O2peak (TTE). Body core temperature (Tcore), mean skin temperature (Tsk), heart rate (HR), thermal comfort, thermal sensation and rating of perceived exertion (RPE) were measured.

RESULTS

Relative to CON, ICE improved TTE by 76.5 ± 96.5% in HUM and 21.3 ± 44.9% in DRY (p = 0.044). End-exercise Tcore was lower in ICE versus CON in DRY (37.8 ± 0.4 °C versus 38.1 ± 0.3 °C, p = 0.005) and HUM (38.8 ± 0.4 °C versus 39.3 ± 0.6 °C, p = 0.004). ICE decreased HR, heat storage and heat strain index only in DRY (p < 0.001-0.018). ICE improved thermal sensation and comfort in DRY and HUM (p < 0.001-0.011), attenuated RPE in HUM (p = 0.012) but not in DRY (p = 0.065).

CONCLUSION

ICE tended to benefit performance in humid heat more than in dry heat. This is likely due to the reduced extent of hyperthermia in dry heat and the relative importance of sensory inputs in mediating exercise capacity.

Upconversion-Luminescent Fiber Microchannel Sensors for Temperature Monitoring at High Spatial Resolution in the Brains of Freely Moving Animals

Brain temperature is a critical factor affecting neural activity and function, whose fluctuations may result in acute life-threatening health complications and chronic neuropathology. To monitor brain temperature, luminescent nanothermometry (LN) based on upconversion nanoparticles (UCNPs) with low autofluorescence has received extensive attention for its advantages in high temperature sensitivity and high response speed. However, most of current the LNs are based on optical imaging, which fails in temperature monitoring in deep brain regions at high spatial resolution. Here, the fiber microchannel sensor (FMS) loaded with UCNPs (UCNP-FMS) is presented for temperature monitoring at high spatial resolution in the deep brains of freely moving animals. The UCNP-FMS is fabricated by incorporating UCNPs in microchannels of optical fibers, whose diameter is ∼50 µm processed by femtosecond laser micromachining for spatially resolved sensing. The UCNPs provide thermal-sensitive upconversion emissions at dual wavelengths for ratiometric temperature sensing, ensuring a detection accuracy of ± 0.3 °C at 37 °C. Superior performances of UCNP-FMS are demonstrated by real-time temperature monitoring in different brain regions of freely moving animals under various conditions such as taking food, undergoing anesthesia/wakefulness, and suffering external temperature changes. Moreover, this study shows the capability of UCNP-FMS in distributed temperature sensing in mammalian brains in vivo.

Effects of ice slurry ingestion on body temperature and softball pitching performance in a hot environment: a randomized crossover trial

BACKGROUND

Although softball players are often required to play in hot environments, scarce evidence is available regarding the effects of ice slurry ingestion on body temperature and pitching performance in softball pitchers in a hot environment. Thus, this study investigated the effects of ice slurry ingestion before and between innings on body temperature and softball pitching performance in a hot environment.

METHODS

In a randomized crossover design, seven heat-acclimatized amateur softball pitchers (four males and three females) completed simulated softball games consisting of 15 best-effort pitches per inning for seven innings with between-pitch rest intervals of 20 s. Participants were assigned to either a control trial (CON: ingestion of 5.0 g·kg^-1 of cool fluid [9.8 ± 2.2 °C] before simulated softball games and 1.25 g·kg^-1 of cool fluid between inning intervals) or an ice trial (ICE: ingestion of ice slurry [- 1.2 ± 0.1 °C] based on the same timings and doses as the CON). Participants performed both trials in an outdoor ground during the summer season (30.8 ± 2.7 °C, 57.0 ± 7.9% relative humidity).

RESULTS

Ice slurry ingestion before the simulated softball game (pre-cooling) resulted in a greater reduction in rectal temperature compared with cool fluid ingestion (p = 0.021, d = 0.68). No significant differences were observed between the trials in rectal temperature changes during the simulated softball game (p > 0.05). Compared to the CON, heart rate during the game was significantly decreased (p < 0.001, d = 0.43), and handgrip strength during the game was significantly increased (p = 0.001, d = 1.16) in the ICE. Ratings of perceived exertion, thermal comfort, and thermal sensation were improved in the ICE compared to those in the CON (p < 0.05). Ball velocity and pitching accuracy were not affected by ICE.

CONCLUSIONS

Ice slurry ingestion before and between innings reduced thermal, cardiovascular, and perceptual strain. However, it did not affect softball pitching performance compared to cool fluid ingestion.

Effects of internal cooling on physical performance, physiological and perceptional parameters when exercising in the heat: A systematic review with meta-analyses

Background: An elevated core temperature (Tcore) increases the risk of performance impairments and heat-related illness. Internal cooling (IC) has the potential to lower Tcore when exercising in the heat. The aim of the review was to systematically analyze the effects of IC on performance, physiological, and perceptional parameters. Methods: A systematic literature search was performed in the PubMed database on 17 December 2021. Intervention studies were included assessing the effects of IC on performance, physiological, or perceptional outcomes. Data extraction and quality assessment were conducted for the included literature. The standardized mean differences (SMD) and 95% Confidence Intervals (CI) were calculated using the inverse-variance method and a random-effects model. Results: 47 intervention studies involving 486 active subjects (13.7% female; mean age 20-42 years) were included in the meta-analysis. IC resulted in significant positive effects on time to exhaustion [SMD (95% CI) 0.40 (0.13; 0.67), p < 0.01]. IC significantly reduced Tcore [-0.19 (22120.34; -0.05), p < 0.05], sweat rate [-0.20 (-0.34; -0.06), p < 0.01], thermal sensation [-0.17 (-0.33; -0.01), p < 0.05], whereas no effects were found on skin temperature, blood lactate, and thermal comfort (p > 0.05). IC resulted in a borderline significant reduction in time trial performance [0.31 (-0.60; -0.02), p = 0.06], heart rate [-0.13 (-0.27; 0.01), p = 0.06], rate of perceived exertion [-0.16 (-0.31; -0.00), p = 0.05] and borderline increased mean power output [0.22 (0.00; 0.44), p = 0.05]. Discussion: IC has the potential to affect endurance performance and selected physiological and perceptional parameters positively. However, its effectiveness depends on the method used and the time point of administration. Future research should confirm the laboratory-based results in the field setting and involve non-endurance activities and female athletes. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022336623.

Active conductive head cooling of normal and infarcted brain: A magnetic resonance spectroscopy imaging study

Active conductive head cooling is a simple and non-invasive intervention that may slow infarct growth in ischemic stroke. We investigated the effect of active conductive head cooling on brain temperature using whole brain echo-planar spectroscopic imaging. A cooling cap (WElkins Temperature Regulation System, 2nd Gen) was used to administer cooling for 80 minutes to healthy volunteers and chronic stroke patients. Whole brain echo-planar spectroscopic imaging scans were obtained before and after cooling. Brain temperature was estimated using the Metabolite Imaging and Data Analysis System software package, which allows voxel-level temperature calculations using the chemical shift difference between metabolite (N-acetylaspartate, creatine, choline) and water resonances. Eleven participants (six healthy volunteers, five post-stroke) underwent 80 ± 5 minutes of cooling. The average temperature of the coolant was 1.3 ± 0.5°C below zero. Significant reductions in brain temperature (ΔT = -0.9 ± 0.7°C, P = 0.002), and to a lesser extent, rectal temperature (ΔT = -0.3 ± 0.1°C, P = 0.03) were observed. Exploratory analysis showed that the occipital lobes had the greatest reduction in temperature (ΔT = -1.5 ± 1.2°C, P = 0.002). Regions of infarction had similar temperature reductions to the contralateral normal brain. Future research could investigate the feasibility of head cooling as a potential neuroprotective strategy in patients being considered for acute stroke therapies.

Performance effects of internal pre- and per-cooling across different exercise and environmental conditions: A systematic review

Exercise in a hot and humid environment may endanger athlete's health and affect physical performance. This systematic review aimed to examine whether internal administration of ice, cold beverages or menthol solutions may be beneficial for physical performance when exercising in different environmental conditions and sports backgrounds. A systematic search was performed in PubMed, Web of Science, Scopus and SPORTDiscus databases, from inception to April 2022, to identify studies meeting the following inclusion criteria: healthy male and female physically active individuals or athletes (aged ≥18 years); an intervention consisting in the internal administration (i.e., ingestion or mouth rinse) of ice slush, ice slurry or crushed ice and/or cold beverages and/or menthol solutions before and/or during exercise; a randomized crossover design with a control or placebo condition; the report of at least one physical performance outcome; and to be written in English. Our search retrieved 2,714 articles in total; after selection, 43 studies were considered, including 472 participants, 408 men and 64 women, aged 18-42 years, with a VO2max ranging from 46.2 to 67.2 mL⋅kg-1⋅min-1. Average ambient temperature and relative humidity during the exercise tasks were 32.4 ± 3.5°C (ranging from 22°C to 38°C) and 50.8 ± 13.4% (varying from 20.0% to 80.0%), respectively. Across the 43 studies, 7 exclusively included a menthol solution mouth rinse, 30 exclusively involved ice slurry/ice slush/crushed ice/cold beverages intake, and 6 examined both the effect of thermal and non-thermal internal techniques in the same protocol. Rinsing a menthol solution (0.01%) improved physical performance during continuous endurance exercise in the heat. Conversely, the ingestion of ice or cold beverages did not seem to consistently increase performance, being more likely to improve performance in continuous endurance trials, especially when consumed during exercises. Co-administration of menthol with or within ice beverages seems to exert a synergistic effect by improving physical performance. Even in environmental conditions that are not extreme, internal cooling strategies may have an ergogenic effect. Further studies exploring both intermittent and outdoor exercise protocols, involving elite male and female athletes and performed under not extreme environmental conditions are warranted. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021268197], identifier [CRD42021268197].

Pre-cooling with ingesting a high-carbohydrate ice slurry on thermoregulatory responses and subcutaneous interstitial fluid glucose during heat exposure

The purpose of this study was to compare the effects of ingesting ice slurries with two different carbohydrate contents on body temperatures and the subcutaneous interstitial fluid glucose level during heat exposure. Seven physically active men underwent one of three interventions: the ingestion of 7.5 g/kg of a control beverage (CON: 26°C), a normal-carbohydrate ice slurry (NCIS: −1°C), or a high-carbohydrate ice slurry (HCIS: −5°C). The participants were monitored for a 120-min period that included 10 min of rest, 25 min of exposure to the experimental cooling intervention (during which the beverage was ingested), and 85 min of seated rest in a climate chamber (36°C, 50% relative humidity). The rectal temperature in the HCIS and NCIS trials was lower than that in the CON trial from 40 to 75 min. The infrared tympanic temperature was also lower in the HCIS and NCIS trials than in the CON trial from 20 to 50 min, whereas the deep thigh or mean skin temperatures were not significantly different among the three groups. From 90 to 120 min, the subcutaneous interstitial fluid glucose level in the NCIS trial was lower than that at 65 min; however, reductions were not seen in the HCIS and CON trials. These findings suggest that both HCIS ingestion and conventional NCIS ingestion were effective cooling strategies for reducing thermal strain, while HCIS ingestion may also enable a higher subcutaneous interstitial fluid glucose level to be maintained, ensuring an adequate supply of required muscle substrates.

Ice slurry ingestion improves physical performance during high-intensity intermittent exercise in a hot environment

Ice slurry ingestion enhances exercise performance by lowering the core body temperature. However, an operational issue related to this ingestion is the requirement for a high intake of 7.5 g·kg^-1 to produce the desired effects. We investigated the effects of the intake of low amounts of ice slurry at −2°C on the tympanic temperature and exercise performance during repeated high-intensity intermittent exercises in a hot environment. This study was a randomized, crossover study, with a 6-day washout period. Twelve university rugby union players performed two 30-min sessions of high-intensity intermittent exercises separated by a 15-min half-time break on a cycle ergometer in a hot environment (28.8°C ± 0.1°C, 49.5% ± 0.6% relative humidity). The participants ingested 450 g of −2°C-ice slurry (ICE), or a 30°C-beverage (CON) having the same composition as ICE, or 30°C-water (WAT) during the half-time break. The tympanic temperature and skin temperature were measured as the physiological data, and the peak power and mean power as the exercise performance data. The tympanic temperature at the half-time break and beginning of the 2^nd session was significantly lower in the ICE group as compared with the CON and WAT groups. The skin temperature at the half-time break was significantly lower in the ICE group as compared with the WAT group. While the peak power and mean power during the 2^nd session were significantly greater in the ICE group as compared with the CON and WAT groups. Our findings suggest that even the intake of lower amounts, as compared with those used in previous studies, of low-temperature ice slurry can reduce the body temperature and improve the peak power. These results suggest that intake of low-temperature ice slurry as a strategy for internal body cooling is useful for improving endurance exercise performance in hot environments.

Case Report: Countermeasures Against Heat and Coronavirus for Japanese Athletes at the Tokyo 2020 Olympics and Paralympic Games

The Tokyo 2020 Olympics and Paralympic Games were held in the hottest environment in the history of the games. Additionally, the worldwide coronavirus disease 2019 (COVID-19) pandemic necessitated daily polymerase chain reaction (PCR) testing during the games, wearing a mask became mandatory publicly, and it was an unheard and unique Olympic with no spectators. Heat acclimation, hydration, and body cooling are essential for safe and high-performance activities in hot environments. In 2015, the Japan Institute of Sports Sciences launched the “Heat Countermeasure Project” to conduct experiments and practical research on heat countermeasures and investigate issues related to heat countermeasures in each athletic event. The results obtained were proposed to various Japan national sports teams, and support for heat countermeasures for the Tokyo 2020 games was promoted in consultation with national federations. Furthermore, due to the COVID-19 pandemic, infectious disease countermeasures for the Tokyo 2020 Games during support were a must. Moreover, athletes, coaches, and team staff could not avoid implementing heat countermeasures while adopting measures against infectious diseases. This study aimed to clarify the issues faced with heat countermeasures and report on heat acclimation training and cooling support efforts, considering measures against infectious diseases.

Ice Ingestion Maintains Cognitive Performance during a Repeated Sprint Performance in The Heat

This study investigated the effects of precooling via crushed ice ingestion on cognitive performance during repeated-sprint cycling in the heat. Nine males, non-heat acclimatised to heat (mean age: 28.2 ± 2.7 y; height: 175.7 ± 9.7 cm; body-mass: 76.9 ± 10.6 kg) completed a 30 min bout of repeated-sprint (36 × 4 s sprints, interspersed with 56 s rest-breaks) on a cycle ergometer in a climate chamber (35°C, 70% relative humidity). Crushed ice ingestion (7g·kg^-1, -0.4°C, ICE) or no cooling (CON) interventions were completed at rest, in the climate chamber, 30 min prior to exercise. Working memory was assessed via the serial seven test (S7) and the automated operation span task (OSPAN) at various time points before, during, and post-exercise. Core body temperature (T_c), forehead temperature (T_h), and thermal sensation (TS) were assessed throughout the protocol. Working memory significantly declined during exercise in CON as measured by S7 (p = 0.01) and OSPAN (p = 0.03); however, it was preserved in ICE with no change at the end of exercise in either S7 or OSPAN scores compared to baseline (p = 0.50, p = 0.09, respectively). Following precooling, T_h (-0.59°C, p < 0.001) and T_c (-0.67°C, p = 0.005) were significantly decreased in ICE compared to CON. At the end of the exercise, ICE significantly reduced T_c compared to CON (p = 0.03), but no significant differences were recorded for T_h. Further, TS was lower following precooling in ICE (p = 0.008) but not during exercise. In conclusion, ice ingestion significantly reduced T_h and T_c and facilitated maintenance of cognitive performance during repeated-sprint exercise in the heat, which may lead to better decision making.

A 3-D virtual human thermoregulatory model to predict whole-body and organ-specific heat-stress responses

Objective

This study aimed at assessing the risks associated with human exposure to heat-stress conditions by predicting organ- and tissue-level heat-stress responses under different exertional activities, environmental conditions, and clothing.

Methods

In this study, we developed an anatomically detailed three-dimensional thermoregulatory finite element model of a 50th percentile U.S. male, to predict the spatiotemporal temperature distribution throughout the body. The model accounts for the major heat transfer and thermoregulatory mechanisms, and circadian-rhythm effects. We validated our model by comparing its temperature predictions of various organs (brain, liver, stomach, bladder, and esophagus), and muscles (vastus medialis and triceps brachii) under normal resting conditions (errors between 0.0 and 0.5 °C), and of rectum under different heat-stress conditions (errors between 0.1 and 0.3 °C), with experimental measurements from multiple studies.

Results

Our simulations showed that the rise in the rectal temperature was primarily driven by the activity level (~ 94%) and, to a much lesser extent, environmental conditions or clothing considered in our study. The peak temperature in the heart, liver, and kidney were consistently higher than in the rectum (by ~ 0.6 °C), and the entire heart and liver recorded higher temperatures than in the rectum, indicating that these organs may be more susceptible to heat injury.

Conclusion

Our model can help assess the impact of exertional and environmental heat stressors at the organ level and, in the future, evaluate the efficacy of different whole-body or localized cooling strategies in preserving organ integrity.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04698-1.

Cooling during short-term heat acclimation enhances aerobic capacity but not sweat capacity

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.

Efficacy of ice slurry and carbohydrate-electrolyte solutions for firefighters

OBJECTIVES

To examine the thermoregulatory and fluid-electrolyte responses of firefighters ingesting ice slurry and carbohydrate-electrolyte solutions before and after firefighting operations.

METHODS

Twelve volunteer firefighters put on fireproof clothing and ingested 5 g/kg of beverage in an anteroom at 25°C and 50% relative humidity (RH; pre-ingestion), and then performed 30 minutes of exercise on a cycle ergometer (at 125 W for 10 minutes and then 75 W for 20 minutes) in a room at 35℃ and 50% RH. The participants then returned to the anteroom, removed their fireproof clothing, ingested 20 g/kg of beverage (post-ingestion), and rested for 90 minutes. Three combinations of pre-ingestion and post-ingestion beverages were provided: a 25℃ carbohydrate-electrolyte solution for both (CH condition); 25℃ water for both (W condition); and a -1.7℃ ice slurry pre-exercise and 25℃ carbohydrate-electrolyte solution post-exercise (ICE condition).

RESULTS

The elevation of body temperature during exercise was lower in the ICE condition than in the other conditions. The sweat volume during exercise was lower in the ICE condition than in the other conditions. The serum sodium concentration and serum osmolality were lower in the W condition than in the CH condition.

CONCLUSIONS

The ingestion of ice slurry while firefighters were wearing fireproof clothing before exercise suppressed the elevation of body temperature during exercise. Moreover, the ingestion of carbohydrate-electrolyte solution by firefighters after exercise was useful for recovery from dehydration.

Ice slurry ingestion before and during exercise inhibit the increase in core and deep-forehead temperatures in the second half of the exercise in a hot environment

Many studies have reported that pre-exercise ice slurry ingestion improves exercise performance; however, it may increase the risk of developing heat stroke. Some studies have suggested that pre-exercise ice slurry ingestion accelerates the core temperature increase that occurs during exercise. Therefore, this study aimed to investigate whether the ingestion of ice slurry before and during exercise can inhibit this acceleration. Moreover, we measured the deep-forehead temperature (T_{deep head}) to determine whether ice slurry ingestion before and during exercise can maintain this reduction in brain temperature. Eleven male participants at room temperature (24 °C, 50% relative humidity [RH]) ingested 7.5 g/kg of ice slurry or a thermoneutral sports drink within 30 min. They then exercised for approximately 60 min at 50% of the maximal oxygen uptake in a hot environment (34 °C, 50% RH) while ingesting 1.25 g/kg of ice slurry or a thermoneutral sports drink every 10 min. Rectal temperature (T_re), T_{deep head}, forehead skin temperature, mean skin temperature, heart rate, nude body mass, and urine specific gravity were measured as physiological indices. The rating of perceived exertion, thermal sensation, and thermal comfort were measured at 5-min intervals throughout the experiment. The T_re and T_{deep head} during the second half of the exercise session were significantly reduced after ingestion of the ice slurry before and during exercise (p < 0.05). In addition, the rate of increase in T_re and T_deephead slowed during the second half of the exercise session after the ingestion of the ice slurry before and during exercise (p < 0.05). These results indicate that the increases in T_re and T_{deep head}, reflecting brain temperature in the second half of the exercise session, were significantly inhibited by ice slurry ingestion before and during exercise.

Efficacy of Oral Cryotherapy During Oxaliplatin Infusion in Preventing Oral Thermal Hyperalgesia: A Randomized Trial

BACKGROUND

Chemotherapy-induced oral thermal hyperalgesia (OTH) is a common and debilitating side effect of platinum-based anticancer agents. This study evaluated the efficacy of oral cryotherapy in preventing OTH during oxaliplatin chemotherapy infusion.

METHODS

Patients with gastrointestinal cancer treated with biweekly oxaliplatin (85 mg/m2 over 120 minutes) at Abramson Cancer Center at the University of Pennsylvania were randomized to receive oral cryotherapy (ice chips) during oxaliplatin infusion or standard-of-care treatment. All patients completed baseline questionnaires regarding oral and peripheral symptoms and on-treatment questionnaires on day 1 of each subsequent chemotherapy cycle. Those in the treatment arm were asked to document how long they kept the ice chips in their mouths (0, <30, 30, 60, 90, or 120 minutes) and to report their discomfort associated with oral cryotherapy. Evaluable patients were those who had completed at least 2 cycles of oxaliplatin therapy.

RESULTS

Of 62 randomized patients with a variety of gastrointestinal malignancies, 50 (25 per treatment arm) were evaluable for efficacy. The rate of patients with oral symptoms after the first treatment cycle was significantly lower in the intervention arm (n=8; 32%) than in the control arm (n=18; 72%), meeting the primary study objective (P=.01). The magnitude of difference in symptom scores before versus after the first treatment cycle was significantly less in the intervention versus control arm (P=.001). No difference in oral symptoms over time was seen between the intervention and control groups (P=.20), although a high attrition rate was noted. Duration of ice chip exposure was associated with improved oral symptoms over time (P=.02).

CONCLUSIONS

Oral cryotherapy is a tolerable and cost-effective method of diminishing OTH in patients receiving oxaliplatin chemotherapy, and seems to be most effective in the early stages of treatment.

Impact of Ice Slurry Ingestion During Break-Times on Repeated-Sprint Exercise in the Heat

The study aimed to investigate the effects of ice slurry ingestion during break times and half-time (HT) on repeated-sprint performance and core temperature in the heat. Seven males performed two different trials as follows: ice slurry (-1°C) or room temperature water ingestion at each break and HT break at 36.5°C, 50% relative humidity. Participants performed 30 sets of 1-min periods of repeated- sprint exercises protocol using a cycling ergometer. Each period consisted of 5 sec of maximal pedaling, 25 sec of pedaling with no workload, and 30 sec of rest; two sets of exercise periods were separated by 10 min of rest. Each break was implemented for 1 min after every 5 sets. The rectal temperature in ice slurry ingestion was significantly lower than that of the room temperature water at 45 set (p=0.04). Total and mean work done was greater in ice slurry ingestion compared to room temperature water ingestion (p < 0.05). These results suggested that ice slurry ingestion during break times and HT break may be an effective cooling strategy to attenuate the rise of core temperature in the second half of exercise and improve the repeated-sprint exercise capacity in the heat.

Enhanced Decision Making and Working Memory During Exercise in the Heat With Crushed Ice Ingestion

PURPOSE

To examine the effects of precooling via crushed ice ingestion on cognitive function during exercise in the heat.

METHODS

Eleven active men ingested either 7 g·kg-1 of crushed ice (ICE) or thermoneutral water (CON) 30 minutes before running 90 minutes on a treadmill at a velocity equivalent to 65% VO2peak in hot and humid conditions (35.0°C [0.5°C], 53.1% [3.9%] relative humidity). Participants completed 3 cognitive tasks to investigate decision making (8-choice reaction time [CRT]), working memory (serial seven [S7]), and executive control (color multisource interference task [cMSIT]) on arrival, after precooling, and after running.

RESULTS

Precooling significantly decreased preexercise core (Tcore) and forehead skin temperature in ICE compared with CON, respectively (Tcore 0.8°C [0.4°C], -0.2°C [0.1°C]; Thead -0.5°C [0.4°C], 0.2°C [0.8°C]; P ≤ .05). Postrun, ICE significantly reduced errors compared with CON for CRT (P ≤ .05; d = 0.90; 90% confidence interval, 0.13-1.60) and S7 (P ≤ .05; d = 1.05; 90% confidence interval, 0.26-1.75). Thermal sensation was lower after precooling with ICE (P ≤ .05), but no significant differences were recorded between conditions for cMSIT errors, skin temperature, heart rate, or ratings of perceived exertion or perceived thirst (P > .05).

CONCLUSIONS

Precooling via ICE maintained cognitive accuracy in decision making and working memory during exercise in the heat. Thus, ICE may have the potential to improve sporting performance by resisting deleterious effects of exercise in a hot and humid environment on cognitive function.

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.

Internal precooling decreases forehead and core temperature but does not alter choice reaction time during steady state exercise in hot, humid conditions

This study aimed to determine if precooling via crushed ice ingestion reduces forehead skin temperature (T_head) and core temperature (T_core) during exercise in the heat and whether it has an effect on choice reaction time (CRT). Ten males commenced a 30 min precooling period, ingesting either 7 g kg^-1 of crushed ice (ICE) or room temperature water (CON) prior to cycling 60 min at 55% V̇O_2peak in hot, humid conditions (35.0 ± 0.3 °C, 50.2 ± 2.1% Relative Humidity). The CRT task was completed upon arrival and after the precooling period in the lab, then at 15 min intervals during exercise in the heat. Precooling reduced T_head and T_core to a greater degree in ICE (T_head: -0.8 ± 0.31 °C; T_core: -0.9 ± 0.3 °C) compared with CON (T_head: -0.2 ± 0.3 °C; T_core: -0.2 ± 0.2 °C) (p ≤ 0.001). Choice reaction time performance improved throughout the cycle for both conditions (p ≤ 0.05). Ice ingestion lowered thermal sensation (p = 0.003) and skin temperature (d = 0.88; T_skin), while heart rate, ratings of perceived exertion and thirst were similar between conditions (p > 0.05). Precooling effectively reduced T_head and T_core but did not provide additional improvement in CRT during moderate exercise in the heat. Further investigation is required to determine whether the lower central and peripheral temperature after ice ingestion is beneficial for tasks of greater cognitive effort.

Ice slurry ingestion during break times attenuates the increase of core temperature in a simulation of physical demand of match-play tennis in the heat

This investigation assessed the effect of ice slurry ingestion compared to that of cold water ingestion during break times on thermal strain and perception in simulated match-play tennis in the heat. Seven male recreational athletes (age = 22 ± 2 yr, height = 1.72 ± 0.08 m, Body mass = 64.8 ± 6.8 kg) performed two trials in a climate chamber, each time completing 4 sets of simulated match-play. During International Tennis Federation-mandated breaks (90-s between odd-numbered games; 120-s between sets), either ice slurry or cold water were ingested. The rectal temperature, forehead skin temperature, heart rate, rating of thermal comfort and total sweat loss were measured. The change in rectal temperature in the ice slurry trial was significantly lower than that in the cold water trial by game 3 of set 3 (p = 0.02). These differences in Δrectal temperature persisted throughout the remainder of the "match" (p < 0.05). Forehead skin temperature, heart rate and rating of thermal comfort were significantly lower in the ice slurry trial than in the cold water trial by the second half of the experiment (p < 0.05). Total sweat loss in ice slurry trial is significantly lower than cold water trial (p = 0.002). These results suggested that ice slurry ingestion was more effective than cold water ingestion in mitigating the development of heat strain during simulated match-play tennis in the heat.

Mixed-methods pre-match cooling improves simulated soccer performance in the heat

This investigation examined the effects of three pre-match and half-time cooling manoeuvres on physical performance and associated physiological and perceptual responses in eight University soccer players during a non-motorised treadmill based individualised soccer-specific simulation [intermittent soccer performance test (iSPT)] at 30°C. Four randomised experimental trials were completed; following 30-min (pre-match) and 15-min (half-time) cooling manoeuvres via (1) ice slurry ingestion (SLURRY); (2) ice-packs placed on the quadriceps and hamstrings (PACKS); (3) mixed-methods (MM; PACKS and SLURRY concurrently); or no-cooling (CON). In iSPT first half, a moderate increase in total (Mean ± Standard Deviation: 108 ± 57 m, qualitative inference: most likely, Cohen's d: 0.87, 90%CL: ±0.31), high-speed (56 ± 46 m, very likely, 0.68 ± 0.38) and variable run (15 ± 5 m, very likely, 0.81 ± 0.47) distance covered was reported in MM compared with CON. Additionally, pre-match reductions in thermal sensation (-1.0 ± 0.5, most likely, -0.91 ± 0.36), rectal (-0.6 ± 0.1°C, very likely, -0.86 ± 0.35) and skin temperature (-1.1 ± 0.3°C, very likely, -0.88 ± 0.42) continued throughout iSPT first half. Physical performance during iSPT first half was unaltered in SLURRY and PACKS compared to CON. Rectal temperature was moderately increased in SLURRY at 45-min (0.2 ± 0.1°C, very likely, 0.67 ± 0.36). Condition did not influence any measure in iSPT second half compared to CON. Only MM pre-match cooling augmented physical performance during iSPT first half, likely due to peripheral and central thermoregulatory factors favourably influencing first half iSPT performance. Further practical half-time cooling manoeuvres which enhance second half performance are still required.