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Effects of Heat Adaptation on Physiology, Perception, and Exercise Performance in the Heat: An Updated Meta-Analysis

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Abstract

Purpose

Heat adaptation (HA) is a popular strategy to combat the negative effects of thermal stress. The HA literature has expanded since a 2016 meta-analysis, and we provide an updated meta-analysis, incorporating 39 additional studies and advanced analysis.

Methods

Following Pubmed searches, full-text original articles using human participants were reviewed using the four-stage PRISMA process. Data were extracted by at least two of the authors. Hedges’ g effect sizes, 95% confidence intervals, and prediction intervals were calculated. Correlations were run where appropriate.

Results

One hundred and thirty-five total articles (96 previous, 39 new) were reviewed. Medium-term (8–14 days), active, constant work HA regimens remain the most common despite a recent focus on isothermal, passive, and short-term (≤ 7 days) alternatives. HA still improves subsequent exercise performance and capacity in the heat (g = 0.7), reduces resting core temperature (g = − 0.6) and heart rate (g = − 0.5), and increases sweat rate (g = 0.4) but the effect sizes are lower than previously reported. HA has a moderate or larger effect (g > 0.5) on lowering sweat onset temperature, mean heart rate, sweat sodium and chloride concentrations, resting thermal sensation, and thirst sensation, and increasing resting plasma volume. There is considerable heterogeneity within the data for most variables.

Conclusion

HA regimens can reduce physiological and perceptual strain and improve subsequent exercise performance and capacity in the heat. Longer regimens may be more effect than shorter ones, but the data are lacking. Passive HA is a practical, effective alternative to active HA.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the lead and corresponding authors on reasonable request.

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Acknowledgements

The authors would like to express gratitude to Dr. David Borg for his assistance with prediction intervals and for producing the prediction interval figures included within the manuscript—his help has undoubtedly improved the manuscript. The authors would also like to thank the authors who provided data when requested.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. School of Life and Health Sciences, University of Roehampton, Danebury Avenue, London, SW15 4JD, England, UK

    Christopher J. Tyler & Tom Reeve

  2. Department of Kinesiology, Brock University, St. Catharines, ON, Canada

    Nina Sieh & Stephen S. Cheung

Authors
  1. Christopher J. Tyler
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  2. Tom Reeve
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  3. Nina Sieh
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  4. Stephen S. Cheung
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Contributions

All authors contributed to the study conception and design. CT conducted the literature review, CT and TR reviewed the review results, CT, TR, NS, and SC extracted data following screening. CT ran the data analysis. CT and SC wrote the first draft of the manuscript. All authors read, edited, and approved the final manuscript.

Corresponding author

Correspondence to Stephen S. Cheung.

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The authors have no relevant financial or non-financial interests to disclose.

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Tyler, C.J., Reeve, T., Sieh, N. et al. Effects of Heat Adaptation on Physiology, Perception, and Exercise Performance in the Heat: An Updated Meta-Analysis. J. of SCI. IN SPORT AND EXERCISE (2024). https://doi.org/10.1007/s42978-023-00263-8

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