Thermoregulation during exercise in the heat in children: old concepts revisited.

Children possess certain physiological and anatomic characteristics that have traditionally been considered to impair thermoregulatory responses to exercise in the heat: low exercise economy, high ratio of body surface area to mass, diminished sweating capacity, and less cardiac output at the same work load compared with adults. Consequently, children have been regarded as an at-risk group for not only decrements of physical performance but also heat injury during physical activities performed in conditions of high ambient temperature. Recent investigations that have directly compared thermoregulatory responses to exercise in the heat in children and adults have challenged these traditional concepts. Such studies have failed to indicate group differences in heat dispersal when adult-child comparisons are appropriately considered in respect to relative exercise intensity. These findings imply that no maturational differences exist in thermal balance or endurance performance during exercise in the heat, nor that child athletes are more vulnerable to heat injury.

[1]  Frank E. Marino,et al.  Advantages of smaller body mass during distance running in warm, humid environments , 2000, Pflügers Archiv.

[2]  O. Bar-or,et al.  Voluntary hypohydration in 10- to 12-year-old boys. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[3]  S. Brun,et al.  The Incidence of Heat Related illness in the Child Athlete in Cairns Far North Queensland Australia and the Associated Environmental Variables: 1056 4:30 PM – 4:45 PM , 2006 .

[4]  Heat-related illnesses, deaths, and risk factors--Cincinnati and Dayton, Ohio, 1999, and United States, 1979-1997. , 2000, MMWR. Morbidity and mortality weekly report.

[5]  B. Saltin,et al.  Esophageal, rectal, and muscle temperature during exercise. , 1966, Journal of applied physiology.

[6]  O. Bar-or,et al.  Sweat gland response to exercise in the heat among pre-, mid-, and late-pubertal boys. , 1992, Medicine and science in sports and exercise.

[7]  Kenneth R. Turley,et al.  Cardiovascular responses to treadmill and cycle ergometer exercise in children and adults , 1997 .

[8]  T. Rowland,et al.  Exercise Tolerance in a Hot and Humid Climate in Heat-Acclimatized Girls and Women , 2006, International journal of sports medicine.

[9]  O. Bar-or,et al.  Drink composition, voluntary drinking, and fluid balance in exercising, trained, heat-acclimatized boys. , 1999, Journal of applied physiology.

[10]  E. Buskirk,et al.  Heat tolerance of exercising lean and obese prepubertal boys. , 1975, Journal of applied physiology.

[11]  G. Borg Psychophysical bases of perceived exertion. , 1982, Medicine and science in sports and exercise.

[12]  Y Epstein,et al.  Role of surface area-to-mass ratio and work efficiency in heat intolerance. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[13]  M. Sawka,et al.  Hydration effects on thermoregulation and performance in the heat. , 2001, Comparative biochemistry and physiology. Part A, Molecular & integrative physiology.

[14]  Joseph Hamill,et al.  An Examination of Efficiency during Walking in Children and Adults , 1992 .

[15]  O. Inbar,et al.  Comparison of thermoregulatory responses to exercise in dry heat among prepubertal boys, young adults and older males , 2004, Experimental physiology.

[16]  D. B. Dill,et al.  Physiological adjustments of young men to five-hour desert walks. , 1976, Journal of applied physiology.

[17]  T. Rowland Developmental Exercise Physiology , 1996 .

[18]  K. Cureton,et al.  Metabolic determinants of the age-related improvement in one-mile run/walk performance in youth. , 1997, Medicine and science in sports and exercise.

[19]  B. Sandick,et al.  Voluntary dehydration and alliesthesia for water. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[20]  Patty S. Freedson,et al.  Is Running Economy Different between Adults and Children , 1996 .

[21]  H. Kaciuba-uścilko,et al.  Gender differences in thermoregulation , 2001, Current opinion in clinical nutrition and metabolic care.

[22]  V. Arora,et al.  Quantum freeze‐out effect in a size‐limited intrinsic transport , 1983 .

[23]  Laxmaiah Manchikanti,et al.  An Invited Review , 1995 .

[24]  T. Rowland,et al.  Physiologic Responses to Treadmill Running in Adult and Prepubertal Males , 1987, International journal of sports medicine.

[25]  O. Bar-or,et al.  Effect of drink flavor and NaCL on voluntary drinking and hydration in boys exercising in the heat. , 1996, Journal of applied physiology.

[26]  J. Bytomski,et al.  Heat illness in children. , 2003, Current sports medicine reports.

[27]  C. Willíams,et al.  Effects of age and recovery duration on performance during multiple treadmill sprints. , 2006, International journal of sports medicine.

[28]  O. Bar-or,et al.  Longitudinal analysis of the sweating response of pre‐, mid‐, and late‐pubertal boys during exercise in the heat , 1992, American journal of human biology : the official journal of the Human Biology Council.

[29]  Thomas W. Rowland,et al.  Children’s Exercise Physiology , 2004 .

[30]  M. Febbraio,et al.  Limits to Exercise Performance in the Heat , 1998, International journal of sports medicine.

[31]  O. Bar-or Climate and the Exercising Child - A Review , 1980 .

[32]  B. Drinkwater,et al.  Response of prepubertal girls and college women to work in the heat. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[33]  T. Araki,et al.  Maturation- and aging-related changes in heat loss effector function. , 2004, Journal of physiological anthropology and applied human science.

[34]  O. Bar-or,et al.  Voluntary dehydration and heat intolerance in cystic fibrosis , 1992, The Lancet.

[35]  Clyde Williams,et al.  Thermoregulatory responses to exercise: relative versus absolute intensity. , 2004, Journal of sports sciences.

[36]  O. Bar-or Climate and the Exercising Child , 1983 .

[37]  O. Bar-or,et al.  Drink composition, voluntary drinking, and fluid balance in exercising, trained, heat-acclimatized boys , 1999 .

[38]  Andrew J. Young,et al.  Perspectives in Exercise Science and Sports Medicine , 1994 .

[39]  O. Bar-or Pediatric Sports Medicine for the Practitioner: From Physiologic Principles to Clinical Applications , 1983 .

[40]  T. Itoh,et al.  Deaths from heat-stroke in Japan: 1968–1994 , 1999, International journal of biometeorology.

[41]  A. Vinet,et al.  Central and peripheral cardiovascular adaptations during a maximal cycle exercise in boys and men. , 2002, Medicine and science in sports and exercise.

[42]  T. Rowland,et al.  Exercise tolerance and thermoregulatory responses during cycling in boys and men. , 2008, Medicine and science in sports and exercise.

[43]  E. Buskirk,et al.  Heat tolerance of exercising lean and heavy prepubertal girls. , 1974, Journal of applied physiology.

[44]  O. Bar-or,et al.  Hypohydration during exercise in children: effect on thirst, drink preferences, and rehydration. , 1994, International journal of sport nutrition.

[45]  J A Stolwijk,et al.  Respiratory weight losses during exercise. , 1972, Journal of applied physiology.

[46]  Roger G. Eston,et al.  Stride Frequency and Submaximal Treadmill Running Economy in Adults and Children , 1990 .

[47]  O. Bar-or,et al.  Effect of drink pattern and solar radiation on thermoregulation and fluid balance during exercise in chronically heat acclimatized children , 1995, American journal of human biology : the official journal of the Human Biology Council.

[48]  O. Bar-or,et al.  Fluid and Electrolyte Loss During Exercise , 1994 .

[49]  J. Wagner,et al.  Heat tolerance and acclimatization to work in the heat in relation to age. , 1972, Journal of applied physiology.

[50]  F. Hainsworth Scaling: why is animal size so important? , 1985 .

[51]  J. Loomis,et al.  Maximal skin vascular conductance in subjects aged 5-85 yr. , 1995, Journal of applied physiology.

[52]  T. Rowland,et al.  Cardiac responses to maximal upright cycle exercise in healthy boys and men. , 1997, Medicine and science in sports and exercise.

[53]  J. Greenleaf,et al.  Drinking and water balance during exercise and heat acclimation. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[54]  G. Havenith Human surface to mass ratio and body core temperature in exercise heat stress—a concept revisited , 2001 .

[55]  Oded Bar-Or,et al.  Pediatric Sports Medicine for the Practitioner , 1983, Comprehensive Manuals in Pediatrics.

[56]  E. Coyle,et al.  Dehydration markedly impairs cardiovascular function in hyperthermic endurance athletes during exercise. , 1997, Journal of applied physiology.

[57]  J. Rees,et al.  Pubertal induction of sweat gland activity. , 1981, Clinical science.

[58]  O. Bar-or,et al.  Sweat electrolyte loss during exercise in the heat: effects of gender and maturation. , 1992, Medicine and science in sports and exercise.

[59]  G. Naughton,et al.  Reducing the risk of heat-related decrements to physical activity in young people. , 2008, Journal of science and medicine in sport.

[60]  T. Rowland,et al.  Mechanical Efficiency During Cycling in Prepubertal and Adult Males , 1990, International Journal of Sports Medicine.

[61]  O. Bar-or,et al.  Thermoregulatory responses of pre-, mid-, and late-pubertal boys to exercise in dry heat. , 1992, Medicine and science in sports and exercise.

[62]  A. Kawahata Sex differences in sweating , 1960 .

[63]  D. Costill,et al.  Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. , 1974, Journal of applied physiology.

[64]  O. Bar-or,et al.  Drink composition and the electrolyte balance of children exercising in the heat. , 1995, Medicine and science in sports and exercise.

[65]  T. Araki,et al.  AGE DIFFERENCES IN SWEATING DURING MUSCULAR EXERCISE , 1979 .

[66]  O. Bar-or,et al.  Children's perceptual responses to ingesting drinks of different compositions during and following exercise in the heat. , 1995, International journal of sport nutrition.

[67]  F. N. Craig,et al.  Heat load and voluntary tolerance time. , 1954, Journal of applied physiology.

[68]  Manabu Shibasaki,et al.  Thermoregulatory responses of prepubertal boys and young men during moderate exercise , 1997, European Journal of Applied Physiology and Occupational Physiology.

[69]  C T Davies,et al.  Thermal responses to exercise in children. , 1981, Ergonomics.