Intermittent exercise-heat exposures and intense physical activity sustain heat acclimation adaptations

Objectives: To determine if intermittent exercise-heat exposures (IHE) every fifth day sustain heat acclimation (HA) adaptations 25 days after initial HA. Design: Randomized control trial. Methods: Sixteen non-heat acclimatized men heat acclimated during 10–11 days of exercise in the heat (40 °C, 40% RH). A heat stress test (120 min, 45% V˙O_2peak) before (Pre HA) and after HA (Post HA) in similar hot conditions assessed HA status. Pair-matched participants were randomized into a control group (CON; n = 7) that exercised in a temperate environment (24 °C, 21%RH) or IHE group (n = 9) that exercised in a hot environment (40 °C, 40%RH) every fifth day for 25 days following HA (+25d) with out-of-laboratory exercise intensity and duration recorded. Both groups completed +25d in the hot condition. Results: Both groups heat acclimated similarly (p > 0.05) evidenced by lower heart rate (HR), thermoregulatory, physiological, and perceptual responses (perceived exertion, fatigue, thermal sensation) Pre HA vs. Post HA (p ≤ 0.05). At +25d, post-exercise HR (p = 0.01) and physiological strain index (p < 0.05) but neither T_re (p = 0.18) nor sweat rate (p = 0.44) were lower in IHE vs. CON. In IHE only, post-exercise T_re and perceptual responses at Post HA and +25d were lower than Pre HA (p ≤ 0.01). +25d post-exercise epinephrine was higher in CON vs. IHE (p = 0.04). Exercise intensity during out-of-lab exercise and +25d post-exercise HR were correlated (r = −0.89, p = 0.02) in IHE. Conclusions: Exercise-heat exposures every fifth day for 25 days and regular intense physical activity after HA sustained HR and T_re adaptations and reduced perceptual and physiological strain during exercise-heat stress ∼1 month later.