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This study aimed to investigate seasonal heat acclimatization in active adolescents following summer. Fifteen (5 females) active adolescents (14.6 ± 1.0 y) completed a 45-min heat response test (HRT) walking at 60% V ˙ O2peak in 40°C and 30% relative humidity before and after summer (i.e. November 2022 and March 2023). During the HRT, gastro-intestinal temperature (Tgi), skin temperature (Tsk), heart rate, local sweat rate (LSR) and whole-body sweat loss (WBSL) were recorded. Carbon monoxide rebreathing and dual-energy X-ray absorptiometry scans determined resting hematological measures and body composition. Participants completed physical activity (PA) diaries and wore an accelerometer for two one-week periods (pre- and post-summer). Daytime wet-bulb globe temperature (WBGT) was calculated for each summer day. Data are presented as posterior mean and 90% credible intervals. Participants reported 7 ± 4 h·wk-1 of outdoor PA, and daytime WBGT was 21.2 ± 4.6°C. Following summer, resting Tgi and heart rate were reduced by 0.2°C [-0.3, -0.1; probability of direction = 99%] and 7 beats·min-1 [-10, -3; 100%], respectively. During the HRT, there was an earlier onset of sweating (-0.2°C [-0.3, -0.0; 98%]), an attenuated rise of Tgi (0.2°C [-0.5, 0.0; 92%]) and mean Tsk changed by -0.2°C [-0.5, 0.1; 86%]. There was minimal evidence for heat adaptations in LSR or WBSL, hematological parameters or perceptual measures. This is the first study to demonstrate seasonal heat adaptations in active adolescents. Reductions in resting Tgi and exercising Tsk and a lower Tgi at the onset of sweating were associated with a smaller rise in Tgi during the HRT following summer.

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OBJECTIVE: To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat. METHODS: 12 males (age: 27±6 years, V̇O2peak: 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C wet-bulb globe temperature) with different cooling configurations: regular match without cooling breaks (REG), 3 min breaks without cooling (BRKno-cool), 3 min breaks with cooling (BRKcool: current FIFA policy; chilled fluid ingestion and ice towel across neck and shoulders), 5 min extended half-time without cooling breaks (ExtHTonly) and 3 min cooling breaks with 5 min ExtHT (ExtHTcool). Rectal temperature (Tre), heart rate, whole-body sweat rate (WBSR) and rating of perceived exertion (RPE) were recorded. Data are presented as mean (95% CIs). RESULTS: Final Tre was lower in BRKno-cool (0.20°C (0.01, 0.39), p=0.038), BRKcool (0.39°C (0.21, 0.57), p<0.001) and ExtHTcool (0.40°C (0.22, 0.58), p<0.001) than REG (39.1°C (38.8, 39.3)). Mean Tre was lower in ExtHTcool (38.2°C (38.0, 38.4)) than BRKcool (38.3°C (38.1, 38.5), p=0.018), BRKno-cool and ExtHTonly (38.4°C (38.2, 38.6), p<0.001) and REG (38.5°C (38.3, 38.7), p<0.001). Mean heart rate was lower during BRKcool (6 beats/min (4, 7), p<0.001) and ExtHTcool (7 beats/min (6, 8), p<0.001) compared with REG. WBSR was comparable across trials (p≥0.07) and RPE was attenuated during BRKcool (0.4 (0.1, 0.7), p=0.004) and ExtHTcool (0.5 (0.2, 0.7), p=0.002), compared with REG. CONCLUSION: BRKcool and ExtHTcool attenuated thermal, cardiovascular and perceptual strain during a simulated football match in the heat. Additional strategies may be required in field settings or under harsher conditions.

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The purpose of this study was to investigate the influence of biological sex, independent of differences in aerobic fitness and body fatness, on the change in gastrointestinal temperature (ΔTgi) and whole body sweat rate (WBSR) of children exercising under uncompensable heat stress. Seventeen boys (means ± SD; 13.7 ± 1.3 yr) and 18 girls (13.7 ± 1.4 yr) walked for 45 min at a fixed rate of metabolic heat production per kg body mass (8 W·kg-1) in 40°C and 30% relative humidity. Sex and peak oxygen consumption (V̇o2peak) were entered into a Bayesian hierarchical general additive model (HGAM) for Tgi. Sex, V̇o2peak, and the evaporative requirement for heat balance (Ereq) were entered into a Bayesian hierarchical linear regression for WBSR. For 26 (12 M and 14 F) of the 35 children with measured body composition, body fat percentage was entered in a separate HGAM and hierarchical linear regression for Tgi and WBSR, respectively. Conditional on sex-specific mean V̇o2peak, ΔTgi was 1.00°C [90% credible intervals (Crl): 0.84, 1.16] for boys and 1.17°C [1.01, 1.33] for girls, with a difference of 0.17°C [-0.39, 0.06]. When sex differences in V̇o2peak were accounted for, the difference in ΔTgi between boys and girls was 0.01°C [-0.25, 0.22]. The difference in WBSR between boys and girls was 0.03 L·h-1 [-0.02, 0.07], when isolated from differences in Ereq. The difference in ΔTgi between boys and girls was -0.10°C [-0.38, 0.17] when sex differences in body fat (%) were accounted for. Biological sex did not independently influence the ΔTgi and WBSR of children exercising under uncompensable heat stress.NEW & NOTEWORTHY Limited studies have investigated the thermoregulatory responses of boys and girls exercising under uncompensable heat stress. Boys and girls often differ in physiological characteristics other than biological sex, such as aerobic fitness and body fat percentage, which may confound interpretations. We investigated the influence of biological sex on exercise thermoregulation in children, independent of differences in aerobic fitness and body fatness.

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BACKGROUND: Athletes and military personnel are often expected to compete and work in hot and/or humid environments, where decrements in performance and an increased risk of exertional heat illness are prevalent. A physiological strategy for reducing the adverse effects of heat stress is to acclimatise to the heat. OBJECTIVE: The aim of this systematic review was to quantify the effects of relocating to a hotter climate to undergo heat acclimatisation in athletes and military personnel. ELIGIBILITY CRITERIA: Studies investigating the effects of heat acclimatisation in non-acclimatised athletes and military personnel via relocation to a hot climate for < 6 weeks were included. DATA SOURCES: MEDLINE, SPORTDiscus, CINAHL Plus with Full Text and Scopus were searched from inception to June 2022. RISK OF BIAS: A modified version of the McMaster critical review form was utilised independently by two authors to assess the risk of bias. DATA SYNTHESIS: A Bayesian multi-level meta-analysis was conducted on five outcome measures, including resting core temperature and heart rate, the change in core temperature and heart rate during a heat response test and sweat rate. Wet-bulb globe temperature (WBGT), daily training duration and protocol length were used as predictor variables. Along with posterior means and 90% credible intervals (CrI), the probability of direction (Pd) was calculated. RESULTS: Eighteen articles from twelve independent studies were included. Fourteen articles (nine studies) provided data for the meta-analyses. Whilst accounting for WBGT, daily training duration and protocol length, population estimates indicated a reduction in resting core temperature and heart rate of - 0.19 °C [90% CrI: - 0.41 to 0.05, Pd = 91%] and - 6 beats·min-1 [90% CrI: - 16 to 5, Pd = 83%], respectively. Furthermore, the rise in core temperature and heart rate during a heat response test were attenuated by - 0.24 °C [90% CrI: - 0.67 to 0.20, Pd = 85%] and - 7 beats·min-1 [90% CrI: - 18 to 4, Pd = 87%]. Changes in sweat rate were conflicting (0.01 L·h-1 [90% CrI: - 0.38 to 0.40, Pd = 53%]), primarily due to two studies demonstrating a reduction in sweat rate following heat acclimatisation. CONCLUSIONS: Data from athletes and military personnel relocating to a hotter climate were consistent with a reduction in resting core temperature and heart rate, in addition to an attenuated rise in core temperature and heart rate during an exercise-based heat response test. An increase in sweat rate is also attainable, with the extent of these adaptations dependent on WBGT, daily training duration and protocol length. PROSPERO REGISTRATION: CRD42022337761.

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PURPOSE: This study aimed to investigate the associations of biological sex and aerobic fitness (i.e., V̇O 2peak ) on the change in gastrointestinal temperature (∆ Tgi ) and whole-body sweat rate (WBSR) of children exercising in warm conditions. METHODS: Thirty-eight children (17 boys, mean ± SD = 13.7 ± 1.2 yr; 21 girls, 13.6 ± 1.8 yr) walked for 45 min at a fixed rate of metabolic heat production (8 W·kg -1 ) in 30°C and 40% relative humidity. Biological sex and relative V̇O 2peak were entered as predictors into a Bayesian hierarchical generalized additive model for Tgi . For a subsample of 13 girls with measured body composition, body fat percent was entered into a separate hierarchical generalized additive model for Tgi . Sex, V̇O 2peak , and the evaporative requirement for heat balance ( Ereq ) were entered into a Bayesian hierarchical linear regression for WBSR. RESULTS: The mean ∆ Tgi for boys was 0.71°C (90% credible interval = 0.60-0.82) and for girls 0.78°C (0.68-0.88). A predicted 20 mL·kg -1 ·min -1 higher V̇O 2peak resulted in a 0.19°C (-0.03 to 0.43) and 0.24°C (0.07-0.40) lower ∆ Tgi in boys and girls, respectively. A predicted ~13% lower body fat in the subsample of girls resulted in a 0.15°C (-0.12 to 0.45) lower ∆ Tgi . When Ereq was standardized to the grand mean, the difference in WBSR between boys and girls was -0.00 L·h -1 (-0.06 to 0.06), and a 20-mL·kg -1 ·min -1 higher predicted V̇O 2peak resulted in a mean difference in WBSR of -0.07 L·h -1 (-0.15 to 0.00). CONCLUSIONS: Biological sex did not independently influence ∆ Tgi and WBSR in children. However, a higher predicted V̇O 2peak resulted in a lower ∆ Tgi of children, which was not associated with a greater WBSR, but may be related to differences in body fat percent between high and low fitness individuals.

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Both adult females and children have been reported to have a lower sweating capacity and thus reduced evaporative heat loss potential that may increase their susceptibility to exertional hyperthermia in the heat. Compared with males, females have a lower maximal sweat rate and thus a theoretically lower maximum skin wettedness due to a lower sweat output per gland. Similarly, children have been suggested to be disadvantaged in high ambient temperatures due to a lower sweat production and therefore reduced evaporative capacity, despite modifications of heat transfer due to physical attributes and possible evaporative efficiency. The reported reductions in the sudomotor activity of females and children suggest a lower sweating capacity in girls. However, because of the complexities of isolating sex and maturation from the confounding effects of morphological differences (e.g., body surface area-to-mass ratio) and metabolic heat production, limited evidence exists supporting whether children, and, more specifically, girls are at a thermoregulatory disadvantage. Furthermore, a limited number of child-adult comparison studies involve females and very few studies have directly compared regional and whole body sudomotor activity between boys and girls. This minireview highlights the exercise-induced sudomotor response of females and children, summarizes previous research investigating the sudomotor response to exercise in girls, and suggests important areas for further research.

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BACKGROUND: Physiological heat adaptations can be induced following various protocols that use either artificially controlled (i.e. acclimation) or naturally occurring (i.e. acclimatisation) environments. During the summer months in seasonal climates, adequate exposure to outdoor environmental heat stress should lead to transient seasonal heat acclimatisation. OBJECTIVES: The aim of the systematic review was to assess the available literature and characterise seasonal heat acclimatisation during the summer months and identify key factors that influence the magnitude of adaptation. ELIGIBILITY CRITERIA: English language, full-text articles that assessed seasonal heat acclimatisation on the same sample of healthy adults a minimum of 3 months apart were included. DATA SOURCES: Studies were identified using first- and second-order search terms in the databases MEDLINE, SPORTDiscus, CINAHL Plus with Full Text, Scopus and Cochrane, with the last search taking place on 15 July 2021. RISK OF BIAS: Studies were independently assessed by two authors for the risk of bias using a modified version of the McMaster critical review form. DATA EXTRACTION: Data for the following outcome variables were extracted: participant age, sex, body mass, height, body fat percentage, maximal oxygen uptake, time spent exercising outdoors (i.e. intensity, duration, environmental conditions), heat response test (i.e. protocol, time between tests), core temperature, skin temperature, heart rate, whole-body sweat loss, whole-body and local sweat rate, sweat sodium concentration, skin blood flow and plasma volume changes. RESULTS: Twenty-nine studies were included in this systematic review, including 561 participants across eight countries with a mean summer daytime wet-bulb globe temperature (WBGT) of 24.9 °C (range: 19.5-29.8 °C). Two studies reported a reduction in resting core temperature (0.16 °C; p < 0.05), 11 reported an increased sweat rate (range: 0.03-0.53 L·h-1; p < 0.05), two observed a reduced heart rate during a heat response test (range: 3-8 beats·min-1; p < 0.05), and six noted a reduced sweat sodium concentration (range: - 22 to - 59%; p < 0.05) following summer. The adaptations were associated with a mean summer WBGT of 25.2 °C (range: 19.6-28.7 °C). LIMITATIONS: The available studies primarily focussed on healthy male adults and demonstrated large differences in the reporting of factors that influence the development of seasonal heat acclimatisation, namely, exposure time and duration, exercise task and environmental conditions. CONCLUSIONS: Seasonal heat acclimatisation is induced across various climates in healthy adults. The magnitude of adaptation is dependent on a combination of environmental and physical activity characteristics. Providing environmental conditions are conducive to adaptation, the duration and intensity of outdoor physical activity, along with the timing of exposures, can influence seasonal heat acclimatisation. Future research should ensure the documentation of these factors to allow for a better characterisation of seasonal heat acclimatisation. PROSPERO REGISTRATION: CRD42020201883.

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