The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.
Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies
Open accessAbstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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“In elite soccer players, the high demands placed on various physiological systems [1,2], metabolism [3,4], and thermoregulation [5,6,7] induce large sweat losses that alter the state of euhydration.”
From Hydration Status of Elite Youth Soccer Players: Training Versus FIFA Competition (2025) · cites this paper as [2]
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Cites
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Functional significance of cell volume regulatory mechanisms
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Physiology of Local Renin-Angiotensin Systems
Paul, M., Poyan Mehr, A., & Kreutz, R. (2006) · Physiological Reviews · doi:10.1152/physrev.00036.2005 · Cited by 1,739
Cellular mechanisms of muscle fatigue
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Exercise and Fluid Replacement
(2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802ca597 · Cited by 1,497
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Biochemistry of exercise-induced metabolic acidosis
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Cited by
Core Temperature Measurement—Principles of Correct Measurement, Problems, and Complications
Hymczak, H., Gołąb, A., Mendrala, K., Plicner, D., Darocha, T., Podsiadło, P., Hudziak, D., Gocoł, R., & Kosiński, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010606 · Cited by 161
Nutritional approaches to counter performance constraints in high‐level sports competition
Burke, L. M. (2021) · Experimental Physiology · doi:10.1113/ep088188 · Cited by 51
Zhang, Y., Li, G., Liu, C., Guan, J., Zhang, Y., & Shi, Z. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1199510 · Cited by 38
Hydration Status of Elite Youth Soccer Players: Training Versus FIFA Competition
Jorquera-Aguilera, C., Droppelmann-Díaz, G., Romero-Vera, L., Andrades-Ramírez, O., Barrientos-Bustamante, C., Cofré-Acevedo, C., Silva-Rojas, J., Araya-Sierralta, S., & Ulloa-Díaz, D. (2025) · Life · doi:10.3390/life15101546 · Cited by 8
Selection Signal Analysis Reveals Hainan Yellow Cattle Are Being Selectively Bred for Heat Tolerance
Wang, L., Yan, X., Wu, H., Wang, F., Zhong, Z., Zheng, G., Xiao, Q., Wu, K., & Na, W. (2024) · Animals · doi:10.3390/ani14050775 · Cited by 5
Effects of heat exposure and ice slurry ingestion on risk-taking behavior in healthcare workers
ALHADAD, S. B., PONAMPALAM, R., LIM, L. S. X., LOW, I. C. C., KSHITIJ, R., ABDUL KARIM, A. B., SALAMOON, Z. B., MARIMUTHU, Y. S., & LEE, J. K. W. (2024) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003486 · Cited by 4
Brown, H. A., John, K., Elliott, J. D., Deshayes, T. A., Gagnon, D., Jay, O., Clark, B., & Périard, J. D. (2026) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00105.2026 · Cited by 2
Self-citationZhuo, F., Gaurani, R. J., Low, I. C. C., Deshayes, T. A., Lee, J. K. W., Cheung, S. S., Choo, P. L., & Tan, X. R. (2026) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2025.200436 · Cited by 1
Metadata
- Authors
- Périard, J. D., Eijsvogels, T. M. H., & Daanen, H. A. M.
- Venue
- Physiological Reviews
- Publisher
- American Physiological Society
- Published
- 2021-10-01
- Volume
- 101
- Issue
- 4
- Pages
- 1873-1979
- ISSN
- 0031-9333 (ISSN-L)
- 1522-1210
- OpenAlex
- W3139937405
- Cited by
- 647
- References
- 67
- FWCI
- 12.69
- Type
- journal article
- Language
- en
- Open access
- green
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