Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake.

BACKGROUND: Maximal oxygen uptake (VO2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO2max responses are unknown. HYPOTHESIS: VO2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA. STUDY DESIGN: Interventional study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT4, IHT8). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO2max, velocity at VO2max (vVO2), and maximal heart rate (HRmax) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc. RESULTS: No significant VO2max or vVO2 differences were observed between baseline, post-HAz, or post-HA (P = 0.36 and P = 0.09, respectively). No significant group or time effects were identified for VO2max or vVO2 at post-HA, IHT4, and IHT8 (P = 0.67 and P = 0.21, respectively). Significant HRmax differences were observed between baseline and post-HA tests (P < 0.01). No significant group or time HRmax differences shown for post-HA, IHT4, and IHT8 (P = 0.59). CONCLUSION: VO2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants' similar aerobic training status and high aerobic fitness levels. CLINICAL RELEVANCE: HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HRmax.

Environmental Stress Symptoms during Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training.

BACKGROUND: Athletes training in heat experience physiological and perceptual symptoms that risk their safety and performance without adaptation. PURPOSE: We examined the changes in environmental symptoms, assessed with the Environmental Symptoms Questionnaire (ESQ), during heat acclimatization (HAz), heat acclimation (HA), and intermittent heat training (HT). METHODS: Twenty-seven participants (mean ± standard deviation [M ± SD], age of 35 ± 12 y, VO2max of 57.7 ± 6.8 mL·kg-1·min-1) completed five trials involving 60 mins of running (60% vVO2max) followed by a 4 km time trial in heat (M ± SD, temperature of 35.5 ± 0.7 °C, humidity of 46.4 ± 1.5%). The trials occurred at baseline, post-HAz, post-HA, at week 4 of HT (post-HT4), and at week 8 of HT (post-HT8). The participants completed HT once/week (HTMIN), completed HT twice/week (HTMAX), or did not complete HT (HTCON). ESQ symptoms, thermal sensation (TS), and heart rate (HR) were measured pre- and post-trial. RESULTS: Post-ESQ symptoms improved post-HA (3[0.40, 4.72], p = 0.02) and post-HAz (3[0.35, 5.05], p = 0.03) from baseline. During HT, symptoms improved in the HTMAX group and worsened in the HTMIN and HTCON groups. Symptoms improved in the HTMAX group versus the HTCON group at post-HT8 (4[1.02, 7.23], p = 0.012). Higher TS and HR values were weakly associated with ESQ symptoms during HT (r = 0.20, p = 0.04), only explaining 20% of variance. CONCLUSIONS: ESQ symptoms improved during HAz, HA, and HT 2x/week. ESQ symptoms were not statistically correlated with HR during exercise heat stress. TS was not sensitive to detecting adaptation and did not subjectively change. The ESQ may be valuable in monitoring adaptation and may contribute to performance post-acclimation.

Efficacy of two intermittent cooling strategies during prolonged work-rest intervals in the heat with personal protective gear compared with a control condition.

INTRODUCTION: Personal protective equipment (PPE) inhibits heat dissipation and elevates heat strain. Impaired cooling with PPE warrants investigation into practical strategies to improve work capacity and mitigate exertional heat illness. PURPOSE: Examine physiological and subjective effects of forearm immersion (FC), fan mist (MC), and passive cooling (PC) following three intermittent treadmill bouts while wearing PPE. METHODS: Twelve males (27 ± 6 years; 57.6 ± 6.2 ml/kg/min; 78.3 ± 8.1 kg; 183.1 ± 7.2 cm) performed three 50-min (10 min of 40%, 70%, 40%, 60%, 50% vVO2max) treadmill bouts in the heat (36 °C, 30% relative humidity). Thirty minutes of cooling followed each bout, using one of the three strategies per trial. Rectal temperature (Tcore), skin temperature (Tsk), heart rate (HR), heart rate recovery (HRR), rating of perceived exertion (RPE), thirst, thermal sensation (TS), and fatigue were obtained. Repeated-measures analysis of variance (condition x time) detected differences between interventions. RESULTS: Final Tcore was similar between trials (P > .05). Cooling rates were larger in FC and MC vs PC following bout one (P < .05). HRR was greatest in FC following bouts two (P = .013) and three (P < .001). Tsk, fluid consumption, and sweat rate were similar between all trials (P > .05). TS and fatigue during bout three were lower in MC, despite similar Tcore and HR. CONCLUSION: Utilizing FC and MC during intermittent work in the heat with PPE yields some thermoregulatory and cardiovascular benefit, but military health and safety personnel should explore new and novel strategies to mitigate risk and maximize performance under hot conditions while wearing PPE.

Using Predictive Modeling Technique to Assess Core Temperature Adaptations from Heart Rate, Sweat Rate, and Thermal Sensation in Heat Acclimatization and Heat Acclimation.

Assessing the adaptation of rectal temperature (Trec) is critical following heat acclimatization (HAz) and heat acclimation (HA) because it is associated with exercise performance and safety; however, more feasible and valid methods need to be identified. The purpose of this study was to predict adaptations in Trec from heart rate (HR), sweat rate (SR), and thermal sensation (TS) using predictive modeling techniques. Twenty-five male endurance athletes (age, 36 ± 12 y; VO2max, 57.5 ± 7.0 mL⋅kg-1⋅min-1) completed three trials consisting of 60 min running at 59.3 ± 1.7% vVO2max in a hot environment. During trials, the highest HR and TS, SR, and Trec at the end of trials were recorded. Following a baseline trial, participants performed HAz followed by a post-HAz trial and then completed five days HA, followed by a post-HA trial. A decision tree indicated cut-points of HR (<-13 bpm), SR (>0.3 L·h-1), and TS (≤-0.5) to predict lower Trec. When two or three variables met cut-points, the probability of accuracy of showing lower Trec was 95.7%. Greater adaptations in Trec were observed when two or three variables met cut-points (-0.71 ± 0.50 °C) compared to one (-0.13 ± 0.36 °C, p < 0.001) or zero (0.0 3 ± 0.38 °C, p < 0.001). Specificity was 0.96 when two or three variables met cut-points to predict lower Trec. These results suggest using heart rate, sweat rate, and thermal sensation adaptations to indicate that the adaptations in Trec is beneficial following heat adaptations, especially in field settings, as a practical and noninvasive method.

Effects of Heat Acclimation Following Heat Acclimatization on Whole Body Heat Exchange in Trained Endurance Athletes.

The purpose of this study was to examine the changes in metabolic heat production (Hprod), evaporative heat loss (Hevap), and dry heat loss (Hdry), following heat acclimatization (HAz) and heat acclimation (HA). Twenty-two male endurance athletes (mean ± standard deviation; age, 37 ± 12 y; body mass, 73.4 ± 8.7 kg; height, 178.7 ± 6.8 cm; and VO2max, 57.1 ± 7.2 mL·kg−1·min−1) completed three trials (baseline; post-HAz; and post-HA), which consisted of 60 min steady state exercise at 59 ± 2% velocityVO2max in the heat (ambient temperature [Tamb], 35.2 ± 0.6 °C; relative humidity [%rh] 47.5 ± 0.4%). During the trial, VO2 and RER were collected to calculate Hprod, Hevap, and Hdry. Following the baseline trial, participants completed self-directed outdoor summer training followed by a post-HAz trial. Then, five days of HA were completed over eight days in the heat (Tamb, 38.7 ± 1.1 °C; %rh, 51.2 ± 2.3%). During the HA sessions, participants exercised to maintain hyperthermia (38.50 °C and 39.75 °C) for 60 min. Then, a post-HA trial was performed. There were no differences in Hprod between the baseline (459 ± 59 W·m−2), post-HAz (460 ± 61 W·m−2), and post-HA (464 ± 55 W·m−2, p = 0.866). However, Hevap was significantly increased post-HA (385 ± 84 W·m−2) compared to post-HAz (342 ± 86 W·m−2, p = 0.043) and the baseline (332 ± 77 W·m−2, p = 0.037). Additionally, Hdry was significantly lower at post-HAz (125 ± 8 W·m−2, p = 0.013) and post-HA (121 ± 10 W·m−2, p < 0.001) compared to the baseline (128 ± 7 W·m−2). Hdry at post-HA was also lower than post-HAz (p = 0.049). Hprod did not change following HAz and HA. While Hdry was decreased following HA, the decrease in Hdry was smaller than the increases in Hevap. Adaptations in body heat exchange can occur by HA following HAz.

Deconstructing stereotypes: Stature, match-playing time, and performance in elite Women's World Cup soccer.

Recruiting companies recommend elite female soccer players be ≥165 cm (5'5″) in stature. This study investigated if stature limits match-playing time and performance in elite World Cup soccer among players, positions, and countries. We hypothesized stature would not affect match-playing time or performance. Descriptive data were collected on 552 players from 2019 FIFA Women's World Cup. Odds ratios determined likelihood of starting for players <165 cm and ≥165 cm. ANOVAs compared playing time between stature groups, among positions, and between countries. Performance factors including assists, goals, attempts, corners, shots blocked, and defending blocks were reported. Independent t-tests compared differences between players (≥165 cm, < 165 cm). Data are reported, mean difference [95% confidence interval] [MD (95%CI)] and effect sizes (ES). On average, 32.3% of players were <165 cm. Of total players, no differences existed in total minutes (F = 0.98, p = 0.32), matches (F = 0.27 p = 0.59), or average minutes per match (F = 0.48, p = 0.49) between stature groups, regardless of position. No differences existed in playing time between players <165 cm and ≥165 cm among any positions (p > 0.05), or between countries (p > 0.05). Taller mid-fielders exhibited greater performance in goals, assists, attempts, shots blocked, and defending blocks (MD [95%CI] ES; assists, -0.44[-0.76,-0.11]0.59, p = 0.009; goals, -0.35[-0.69,-0.01]0.44, p = 0.047); attempts, 3.14[1.38, 4.90]0.80, p = 0.001; corners, 2.04[0.12, 3.95]0.48, p = 0.037; shots blocked, 0.96[0.40, 1.51]0.75, p = 0.001; defending blocks, 0.43[0.32,0.82]0.48, p = 0.035), however, actual differences were minimal. Our findings indicate stature does not inhibit playing and performing elite women's soccer, as nearly one-third of players were <165 cm.

Effects of Heat Acclimatization, Heat Acclimation, and Intermittent Exercise Heat Training on Time-Trial Performance.

BACKGROUND: The purpose of this study was to investigate effects of heat acclimatization (HAz) followed by heat acclimation (HA), and intermittent heat training (IHT) on time-trial performance. HYPOTHESIS: Time-trial performance will improve after HA and will further improve with twice a week of IHT. STUDY DESIGN: Interventional study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 26 male athletes (mean ± SD; age, 35 ± 12 years; body mass, 72.8 ± 8.9 kg; peak oxygen consumption [VO2peak], 57.3 ± 6.7 mL·kg-1·min-1) completed five 4-km time trials (baseline, post-HAz, post-HA, post-IHT4, post-IHT8) in the heat (ambient temperature, 35.4°C ± 0.3°C; relative humidity, 46.7% ± 1.2%) on a motorized treadmill. After baseline time trial, participants performed HAz (109 ± 10 days) followed by post-HAz time trial. Then, participants completed 5 days of HA, which involved exercising to induce hyperthermia (38.50°C-39.75°C) for 60 minutes. Participants were then divided into 3 groups and completed IHT either twice per week (IHTMAX), once per week (IHTMIN), or not at all (IHTCON) over an 8-week period. The exercise used for the IHT matched the HA. Four-kilometer time trials were performed after 4 weeks (post-IHT4) and 8 weeks of IHT (post-IHT8). RESULTS: Time trial was faster in post-HA (17.98 ± 2.51 minutes) compared with baseline (18.61 ± 3.06 minutes; P = 0.037) and post-HAz (18.66 ± 3.12 minutes; P = 0.023). Percentage change in time trial was faster in IHTMAX (-3.9% ± 5.2%) compared with IHTCON (11.5% ± 16.9%) (P = 0.020) and approached statistical significance with large effect (effect size = 0.96) compared with IHTMIN (1.6% ± 6.2%; P = 0.059) at post-IHT8. Additionally, IHTMAX (-2.2% ± 4.2%) was faster than IHTCON (3.6% ± 6.9%) (P = 0.05) at post-IHT4. CONCLUSION: These results indicate that HA after HAz induces additional improvement in time-trial performance. IHT twice per week shows improvement after 8 weeks, while once per week maintains performance for 8 weeks. No IHT results in a loss of adaptations after 4 weeks and even greater losses after 8 weeks. CLINICAL RELEVANCE: HA after HAz improves time-trial performance, twice a week of IHT improves performance further, and once a week of IHT maintains performance for at least 8 weeks.

The efficacy of weekly and bi-weekly heat training to maintain the physiological benefits of heat acclimation.

OBJECTIVES: To examine the efficacy of weekly and bi-weekly heat training to maintain heat acclimatization (HAz) and heat acclimation (HA) for 8 weeks in aerobically trained athletes. DESIGN: Randomized, between-group. METHODS: Twenty-four males (mean [m ±â€¯standard deviation [sd]; (age, 34 ±â€¯12 y; body mass, 72.6 ±â€¯8.8 kg, VO2peak, 57.7 ±â€¯6.8 mL·kg-1·min-1) completed five trials (baseline, following HAz, following HA (HAz + HA), four weeks into heat training [HTWK4], and eight weeks into HT [HTWK8] that involved 60 min of steady-state exercise (59.1 ±â€¯1.8% vVO2peak) in an environmental laboratory (wet bulb globe temperature [WBGT], 29.6 ±â€¯1.4 °C) on a motorized treadmill. Throughout exercise, heart rate (HR) and rectal temperature (Trec) were recorded. Following HAz + HA, participants were assigned to three groups: control group (HT0), once per week heat training (HT1), and twice per week heat training (HT2). HT involved heated exercise (WBGT, 33.3 ±â€¯1.3 °C) to achieve hyperthermia (38.5-39.75 °C) for 60 min. Repeated measures ANOVAs were used to determine differences. RESULTS: HAz + HA resulted in significant improvements in HR (p < 0.001) and Trec (p < 0.001). At HTWK8, HR was significantly higher in HT0 (174 ±â€¯22 beats⋅min-1) compared to HT2 (151 ±â€¯17 beats⋅min-1, p < 0.023), but was not different than HT1 (159 ±â€¯17 beats⋅min-1, p = 0.112). There was no difference in % change of Trec from post-HAz + HA to HTWK4 (0.6 ±â€¯1.3%; p = 0.218), however, HTWK8 (1.8 ±â€¯1.4%) was significantly greater than post-HAz + HA in HT0 (p = 0.009). CONCLUSIONS: Bi-weekly HT provided clear evidence for the ability to maintain physiological adaptions for 8 weeks following HA.

Changes in Hydration Factors Over the Course of Heat Acclimation in Endurance Athletes.

The purpose of this study was to examine the effect of heat acclimation (HA) on thirst levels, sweat rate, and percentage of body mass loss (%BML), and changes in fluid intake factors throughout HA induction. Twenty-eight male endurance athletes (mean ± SD; age, 35 ± 12 years; body mass, 73.0 ± 8.9 kg; maximal oxygen consumption, 57.4 ± 6.8 ml·kg-1·min-1) completed 60 min of exercise in a euhydrated state at 58.9 ± 2.3% velocity of maximal oxygen consumption in the heat (ambient temperature, 35.0 ± 1.3 °C; relative humidity, 48.0 ± 1.3%) prior to and following HA where thirst levels, sweat rate, and %BML were measured. Then, participants performed 5 days of HA while held at hyperthermia (38.50-39.75 °C) for 60 min with fluid provided ad libitum. Sweat volume, %BML, thirst levels, and fluid intake were measured for each session. Thirst levels were significantly lower following HA (pre, 4 ± 1; post, 3 ± 1, p < .001). Sweat rate (pre, 1.76 ± 0.42 L/hr; post, 2.00 ± 0.60 L/hr, p = .039) and %BML (pre, 2.66 ± 0.53%; post, 2.98 ± 0.83%, p = .049) were significantly greater following HA. During HA, thirst levels decreased (Day 1, 4 ± 1; Day 2, 3 ± 2; Day 3, 3 ± 2; Day 4, 3 ± 1; Day 5, 3 ± 1; p < .001). However, sweat volume (Day 1, 2.34 ± 0.67 L; Day 2, 2.49 ± 0.58 L; Day 3, 2.67 ± 0.63 L; Day 4, 2.74 ± 0.61 L; Day 5, 2.74 ± 0.91 L; p = .010) and fluid intake (Day 1, 1.20 ± 0.45 L; Day 2, 1.52 ± 0.58 L; Day 3, 1.69 ± 0.63 L; Day 4, 1.65 ± 0.58 L; Day 5, 1.74 ± 0.51 L; p < .001) increased. In conclusion, thirst levels were lower following HA even though sweat rate and %BML were higher. Thirst levels decreased while sweat volume and fluid intake increased during HA induction. Thus, HA should be one of the factors to consider when planning hydration strategies.

Availability of a Flavored Beverage and Impact on Children's Hydration Status, Sleep, and Mood.

Euhydration remains a challenge in children due to lack of access and unpalatability of water and to other reasons. The purpose of this study was to determine if the availability/access to a beverage (Creative Roots®) influences hydration in children and, therefore, sleep quality and mood. Using a crossover investigation, 46 participants were randomly assigned to a control group (CON) or an intervention group and received Creative Roots® (INT) for two-week periods. We recorded daily first morning and afternoon urine color (Ucol), thirst perception, and bodyweight of the two groups. Participants reported to the lab once per week and provided first morning urine samples to assess Ucol, urine specific gravity (USG), and urine osmolality (Uosmo). Participants also completed the questionnaires Profile of Mood States-Adolescents (POMS-a) and Pittsburgh Sleep Quality Index (PSQI). Dependent t-tests were used to assess the effects of the intervention on hydration, mood, and sleep quality. Uosmo was greater and Ucol was darker in the control group (mean ± SD) [Uosmo: INT = 828 ± 177 mOsm·kg-1, CON = 879 ± 184 mOsm·kg-1, (p = 0.037], [Ucol:INT = 5 ± 1, CON = 5 ± 1, p = 0.024]. USG, POMS-a, and PSQI were not significant between the groups. At-home daily afternoon Ucol was darker in the control group [INT = 3 ± 1, CON = 3 ± 1, p = 0.022]. Access to Creative Roots® provides a small, potentially meaningful hydration benefit in children. However, children still demonstrated consistent mild dehydration based on Uosmo, despite consuming the beverage.

Heat Acclimation Following Heat Acclimatization Elicits Additional Physiological Improvements in Male Endurance Athletes.

The purpose of this study was to assess the effectiveness of heat acclimatization (HAz) followed by heat acclimation (HA) on physiological adaptations. 25 male endurance athletes (age 36 ± 12 y, height 178.8 ± 6.39 cm, body mass 73.03 ± 8.97 kg, and VO2peak 57.5 ± 7.0 mL·kg-1·min-1) completed HAz and HA. HAz was 3 months of self-directed summer training. In the laboratory, a 5-day HA prescribed exercise to target a hyperthermic zone (HZHA) of Trec between 38.50 and 39.75 °C for 60 min. Exercise trials were 60 min of running (59% ± 2% VO2peak) in an environmental chamber (wet bulb globe temperature 29.53 ± 0.63 °C) and administered at: baseline, post-HAz, and post-HAz+HA. Measured variables included internal body temperature (Trec), heart rate (HR), and sweat rate (SR). Repeated measure ANOVAs and post hoc comparisons were used to assess statistically significant (p < 0.05) differences. Trec was lower post-HAz+HA (38.03 ± 0.39 °C) than post-HAz (38.25 ± 0.42 °C, p = 0.009) and baseline (38.29 ± 0.37 °C, p = 0.005). There were no differences between baseline and post-HAz (p = 0.479) in Trec. HR was lower post-HAz (143 ± 12 bpm, p = 0.002) and post-HAz+HA (134 ± 11 bpm, p < 0.001) than baseline (138 ± 14 bpm). HR was lower post-HAz+HA than post-HAz (p = 0.013). SR was higher post-HAz+HA (1.93 ± 0.47 L·h-1) than post-HAz (1.76 ± 0.43 L·h-1, p = 0.027). Combination HAz and HA increased physiological outcomes above HAz. This method can be used to improve performance and safety in addition to HAz alone.