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OLYMPIC GAMES TOKYO 2020 - cloudfront.net
OLYMPIC GAMES TOKYO 2020
OLYMPIC GAMES TOKYO 2020 - cloudfront.net
Beat The Heat during the
Olympic Games Tokyo 2020

 10 TOP TIPS
 1.    eat acclimatisation by training in the
      H                                            6.     o not use clothing that limits sweat
                                                         D
      heat for at least two weeks. [see p. 7, 9]         evaporation. [see p. 14]

 2.	
    If you cannot acclimatise for two weeks,       7.     any medications can impair your
                                                         M
      try at least one week! [see p. 8, 10]              ability to tolerate heat, so discuss your
                                                         medications with your sports physician.
 3.	
    Implement your hydration plan starting
      in the days preceding the event.             8.     iarrhoea and vomiting impair your
                                                         D
      [see p. 11–13]                                     hydration status and will require the use
                                                         of Oral Rehydration Solutions (ORS).
 4.    se pre-cooling strategies during your
      U
      warm-up (e.g. ice vest). [see p. 14]         9.     se a non-greasy sunscreen.
                                                         U
                                                         [see p. 14]
 5.	
    Test your cooling strategies during
      practice prior to the event/competition.     10.    se a hat and Category 3 sunglasses.
                                                         U
      [see p. 14]                                        [see p. 14]

                                                                                                     2
OLYMPIC GAMES TOKYO 2020 - cloudfront.net
Beat The Heat during the
Olympic Games Tokyo 2020

 The Games of the XXXII Olympiad Tokyo
 2020 (24 Jul – 9 Aug) will take place in                              34                                                                   92
                                                                       32
 hot and humid environmental conditions.                                                                                                    88
                                                                       30
                                                                                                                                            84
 Hot and humid ambient conditions limit                                28
                                                                                                                                            80
 heat dissipation capacity during exercise,                            26
                                                                       24                                                                   76
 thus impairing endurance performance
                                                                       22                                                                   72
 and increasing the risk of exertional
                                                                       20                                                                   68
 heat illness such as heat cramps, heat                                     0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
 exhaustion and heat stroke.                                                                          Hour (local)
 The risk of heat-related illness can be
 reduced by adopting countermeasures                                   95
 such as heat acclimatisation.                                         90
                                              Relative Humidity (%)

                                                                       85
 This document addresses some
                                                                       80
 “Frequently Asked Questions”                                          75
 about performing in hot and humid                                     70
 ambient conditions and provides                                       65
 recommendations to optimise                                           60
 performance and reduce the risk                                            0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
 of heat illness.                                                                                     Hour (local)

                                                                      Figure 1: Typical Tokyo weather during 24 July – 9 August Olympic period
                                                                      (Tokyo airport average data from 1998–2018)

                                                                                                                                                 3
OLYMPIC GAMES TOKYO 2020 - cloudfront.net
How is body temperature maintained?

                                                        Figure 2: The athletes’ thermal environment
                                                                                                                                      The ambient conditions during          When resting in temperate
                                                             Radiation
                                                                                                                                      sporting events are generally          environmental conditions, core
                                                                                                                                      determined using the Wet-Bulb-         body temperature in humans is
                                                                                                                                      Globe-Temperature (WBGT) index.        around 37ºC, while muscle and
                                                                                                                                      The WBGT is calculated from            skin temperature is approximately
                                                                                                                                      the dry (standard thermometer)         35ºC and 31ºC, respectively. During
                              (solar radiation – direct or
                          reflected towards the athlete)
                                                                         (evaporative heat loss by
                                                                         radition from the body)                                      temperature, the wet-bulb              physical exertions, such as running
                                                                                                                                      temperature (indicative of the true    or race-walking, muscle contractions
                                                                                                                                      capacity of the air to evaporate       produce a considerable amount of
                                                                                                      Convection                      water according to its relative        heat, inducing a large increase in
                                                                                                      (requires air flow at a lower
                                                                                                      temperature than the skin for   humidity and air velocity) and the     muscle temperature which drives an
                                                                                                      negative cooling effect)
                                                                                                                                      solar radiation (globe temperature).   increase in core body temperature.
                                                                                                                                      Thus, both a hot and dry (e.g.         The heat produced is dissipated
                                                                                                                                      37ºC, 25% relative humidity as         into the environment via the skin
                                                                                                                                      during the 2016 UCI Road World         through sensible (i.e. convection and
       Sweat evaporation                                                                                                              Championships in Qatar) or a warm      radiation) and insensible evaporation
(main avenue for heat dissipation
        in the exercising human)                                                                                                      and humid (e.g. 28ºC, 75% relative     heat loss pathways, primarily in the
                                                                                                                                      humidity as during the 2014 FIFA       form of sweating. In hot ambient
                                                                                                                                      World Cup in Brazil) environment       conditions, the gradient between
                                                                                                                                      can produce the same WBGT (27ºC).      skin and environmental temperature
                                                                                                     Metabolic production
                                                                                                     (¼ of the energy is converted                                           is minimal, possibly even negative,
                                                                                                     into mechanical work,            
                                                                                                     ¾ is converted into heat)                                               such that heat dissipation occurs
                                                                                                                                                                             mainly through sweat evaporation.

                                                                                                                                                                              BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020   4
OLYMPIC GAMES TOKYO 2020 - cloudfront.net
How does heat affect performance?

          Figure 3: The effect of temperature on running performance
                                                                                                                                                  An increase in muscle temperature (e.g. through
                                                                                                                                                  warm-up) has several benefits for explosive athletic
                                                                                                                                                  performance such as sprints, jumps and throws.
                                                      1.0
                                                                                                                                                  However, preventing an excessive rise in core body
                                                                                                                                                  temperature during prolonged exercise requires
                                                      0.5                                                                                         transferring metabolic heat from the working
                                                                                                                                                  muscles and core to the skin and then dissipating
           Change in performance >25°C versus
OLYMPIC GAMES TOKYO 2020 - cloudfront.net
What is the normal body temperature
response during exercise?

          Figure 4: Maximal body core temperature when competing in the heat
                                                                               Body temperature increases after a few minutes
                                                                               of exercise. The heat dissipation capacity of the
                                                                               environment is determined by air temperature,
                                                                               radiant temperature, humidity and air velocity.
                                                                               The athlete’s personal potential for heat loss is
                                                                               determined by their acclimatisation status, sweat
                                                                               rate, clothing and fitness. The environment together

                                                           Core                with the individual athlete’s potential for heat loss
                                                                               will determine to what extent their core temperature
                                                           Body temperature    will increase.
                                                           can reach between   Core temperature will keep rising during exercise
                                                                               unless heat production is reduced (e.g. reduce
                                                           39–410C             speed). Depending on the intensity and duration of
                                                                               the exercise, a plateau in body temperature may
                                                                               occur anywhere around 38.5–40ºC when exercising
                                                                               in temperate environments.

                                                                               However, athletes can transiently achieve a core
                                                                               body temperature above 41ºC when competing
                                                                               intensely in hot ambient conditions.

                                                                                               BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020   6
How best to prepare for competition
in the heat

           Figure 5: Adaptations to repeated training in
           the heat for unacclimatised athletes                                                                                      The best way to prepare for            It is therefore recommended
                                                                                                                                     competition in the heat is to          that athletes train in a similar
                                                                                                                                     train in the heat (i.e. to heat        environment to that in which
                                  120                                                                                                acclimatise).  Heat adaptation         competition will occur,
                                                                                                                                          Exercise Capacity
                                                                                                                                     is achieved via repeated               commencing heat adaptation
                                                                                                                                          Thermal Comfort
                                                                                                                                     exercise/heat    exposure that         at least two weeks prior to
                                                                                                                                     increases   body   core and            competition.
           Adaptation (% Day 1)

                                                                                                                                          Sweating   Rate
                                                                                                                                     skin temperature, as well as
                                                                                                                                          Skin Temperature
                                                                                                                                     inducing   significant sweating.       Conducting an initial heat
                                                                                                                                                                            acclimatisation camp several
                                  100                                                                                                        Core Temperature
                                                                                                                                     This adaptation to the                 weeks before the target event
                                                                                                                                     heat Heart
                                                                                                                                            can be  achieved using
                                                                                                                                                  Rate                      may also enhance the rate
                                                                                                                                     hot ambient conditions                 of adaptation to the heat in
                                                                                                                                           Plasma Volume
                                                                                                                                     (i.e. acclimatisation) or              a follow-up pre-competition
                                                                                                                                     by simulating hot ambient              camp. The most visible body
                                                                                                                                     conditions using purpose-              adaptations to repeated
                                   80                                                                                                built environmental chambers           training in the heat include
                                                           0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
                                                                                                                                     or improvised low-tech “hot            an increased sweat rate,
                                                           120               Days of Heat Acclimation                                rooms” (i.e. acclimation).             a decreased heart rate at
                                                                                                        Exercise Capacity
                                                                                                        Thermal Comfort              The number of days required            a given intensity, a better
                                                                                                                                     to achieve optimal adaptation          retention of electrolytes,
                                    Adaptation (% Day 1)

                                                                                                        Sweating Rate
                                                                                                        Skin Temperature             varies between individuals,            and a decreased body
                                                           100                                          Core Temperature             but most adaptations tend              core temperature.
                          Source: Périard, J. D., Racinais, S. & Sawka, M. N. Scand                     Heart Rate                          TT in the
                                                                                                                                     to develop       heat7–10
                                                                                                                                                   within  without  training in the heat
                                                                                                                                                                 days,
                             350Sci Sports 25, 20–38 (2015).
                          J Med                                                                         Plasma Volume                with 14 days being optimal
                                                                                                                                            TT in the heat after 1 week of training in the heat
                                                                                                                                     for most.
                                                            80
                                                                 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14                                          TT in the heat after 2 weeks of training in the heat

                                  300
                                                                          Days of Heat Acclimation
                                                                                                                                             TT in cool environment
           er output (W)

                                                                                                                                                                      BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020   7
                                                                                                        TT in the heat without training in the heat
                                                           350
                                                                                                        TT in the heat after 1 week of training in the heat
Thermal Comfort

                                  Adaptation (% Day 1)
                                                                                                                                                                                 Sweating Rate

How much can performance be
                                120
                                                                                                                          Exercise Capacity                                      Skin Temperature
                                                                                                                          Thermal Comfort
                                                         100                                                                                                                     Core Temperature

         Adaptation (% Day 1)
                                                                                                                          Sweating Rate

improved by heat acclimatisation?
                                100
                                                                                                                          Skin Temperature
                                                                                                                          Core Temperature
                                                                                                                          Heart Rate
                                                                                                                                                                                 Heart Rate
                                                                                                                                                                                 Plasma Volume
                                                                                                                          Plasma Volume

                                 80                       80
                                             0 1 2 3 04 51 6 27 8 3 9 10
                                                                      4 11 512 136 14                          7 8 9 10 11 12 13 14
                                 Figure 6: The     impact
                                              Days of            of heat acclimatisation on cycling
                                                      Heat Acclimation
                                                                      Days of Heat Acclimation
                                 time trial (TT) performance in the heat                                                                                                                Heat stress can dramatically decrease endurance
                                                                                                                                                                                        performance, but this reduction in performance
                                                                                                                          TT in the heat without training in the heat                   can be mitigated progressively with heat
                                350
                                                                                                                          TT in the heat after 1 week of training in the heat           acclimatisation. Heat acclimatisation is an ideal
                                                                                                                          TT in the heat after 2 weeks of training in the heat          adjunct to other performance-enhancing strategies
                                                                                                                                                                                 TT in the heat
                                                                                                                                                                                        (e.g.    without training
                                                                                                                                                                                              high-altitude        in theHeat
                                                                                                                                                                                                            training).    heatacclimatisation
                                300                      350                                                              TT in cool environment
                                                                                                                                                                                        willheat
                                                                                                                                                                                             alsoafter
                                                                                                                                                                                                  reduce  the of
                                                                                                                                                                                                               risk of heat-related
                                                                                                                                                                                                                           in the heatillness.
         Power output (W)

                                                                                                                                                                                 TT in the             1 week     training

                                250
                                                                                                                                                                                        If the
                                                                                                                                                                                 TT in the  heatsigns
                                                                                                                                                                                                  afterand symptoms
                                                                                                                                                                                                        2 weeks         of heat-related
                                                                                                                                                                                                                of training in the heat illness
                                                                                                                                                                                       develop then:
                                                         300                                                                                                                     TT in cool environment
                                                                                                                                                                                         • Call for medical assistance
                                  Power output (W)

                                200
                                         10              20   30    40   50   60    70    80       90    100

                                                               Percent distance completed (43km)
                                                                                                                                                                                         • R
                                                                                                                                                                                            emove the individual from the heat source
                                                                                                                                                                                           (e.g. from out of the sun to shade)
                                                         250
                                                                                                                                                                                         • Where possible start active cooling

                                                                                                                                                                                       Therefore, heat acclimatisation should be a
                                                                                                                                                                                       priority before any event where hot and/or humid
                                                         200                                                                                                                           conditions are likely or expected. Indeed, heat
                                                               10        20     30        40            50      60   70    80       90        100
                                                                                                                                                                                       acclimatisation does not impair performance
                                                                                    Percent distance completed (43km)                                                                  in cooler environments and may even enhance
                                                                                                                                                                                       performance under certain conditions.
                                    Source: Racinais, S., Périard, J. D., Karlsen, A. & Nybo,
                                    L. Med Sci Sports Exerc 47, 601–606 (2015).

                                                                                                                                                                                                          BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020   8
How to heat acclimatise in a cold country

           Figure 7: The different heat acclimatisation methods                                                                                                 HEAT
                                                                                                                                                                  There are a wide variety of                           overall benefits of passive
                                                                                                              ACCLIMATISATION approaches that can increase                                              ACCLIMATION     heat acclimation will be
                                                                           HEAT                                       Natural Environment                         core and skin temperature                             less than training in hot
                                                                                                                                                                                                         Artificial Environment
                                                                                                                     (outdoor/field training)                      and stimulate sweating.            (indoor/laboratory    training) conditions. Water
                                                                                                                                                                                                                        ambient
                          ACCLIMATISATION                                                          ACCLIMATION                                                                                                          temperature should be
                                 Natural Environment                                                Artificial Environment                                         The first choice should be
                                (outdoor/field training)                                         (indoor/laboratory training)                                                                                            around 40ºC in order to elicit
                                                                                                                                                                  to train for 60–90 minutes
                                                                                                                                                                                                                        adaptation while remaining
                                                                                                 SELF-PACED                                CONSTANT a day               CONTROLLED
                                                                                                                                                                           in the same ambient      CONTROLLED                      PASSIVE
                                                                                                    EXERCISE                              WORK RATE conditions            INTENSITY                HYPERTHERMIA         tolerableHEATING
                                                                                                                                                                                                                                       (this can easily be
                                                                                                                                                                                     as the upcoming
               SELF-PACED                    CONSTANT                 CONTROLLED               CONTROLLED                       PASSIVE                                                                                 measured with a floating
                EXERCISE                     WORK RATE                 INTENSITY              HYPERTHERMIA                      HEATING                           competition for two weeks.
                                                                                                                                                                                                                        pool thermometer).
                                                                                                                                                                  However, if this is not
                                                                                                                                                                  possible, most adaptations                            Another approach to induce
                                                                                                                                                                  can be acquired by artificially                       heat adaptation is to
                 ACTIVITY                     ACTIVITY                  ACTIVITY                    ACTIVITY
                                                                                                  ACTIVITY                     ACTIVITY      ACTIVITY             simulating
                                                                                                                                                                           ACTIVITY  heat    during    indoor
                                                                                                                                                                                                       ACTIVITY wear extra         ACTIVITYclothing during
               Football, running, etc.        Walking at 6km/h,
                                             running at 12km/h,
                                                                       Cycle ergometer at
                                                                      65% VO2max heart rate
                                                                                                  Work +/– Rest to
                                                                                                 Football,  running,
                                                                                                   maintain core
                                                                                                                      etc.    Water immersion,
                                                                                                                                           Walking at 6km/h,
                                                                                                                               or sauna bathing
                                                                                                                                           running at 12km/h,
                                                                                                                                                                  trainingCycle (i.e.   use
                                                                                                                                                                                ergometer at  of a purpose-
                                                                                                                                                                                                      Work +/– Rest to trainingWater
                                                                                                                                                                                                        maintain core
                                                                                                                                                                                                                                     to   increase
                                                                                                                                                                                                                                         immersion,
                                                                                                                                                                                                                                   or sauna bathing
                                                                                                                                                                                                                                                       the
                                           cycle ergometer at 185 W                            temperature at 38.5°C                                                    65% VO heart rate
               CONDITIONS                                                (e.g. 145 bpm)
                                                                                                CONDITIONS CONDITIONS
                                                                                                                                       cycle   ergometer at 185 W built environmental
                                                                                                                                                                  2max
                                                                                                                                                                            (e.g. 145 bpm)        chamber
                                                                                                                                                                                                    temperature at      heat stimulus. Collectively,
                                                                                                                                                                                                                   38.5°C
                 Outdoor (variable)         CONDITIONS                CONDITIONS               CONDITIONS                       Water 40–42°C                                                                                   CONDITIONS
               Indoor (40°C, 40%RH)           Outdoor (variable)
                                            Indoor (40°C, 40%RH)
                                                                      Indoor (40°C, 40%RH)
                                                                                                   Outdoor (variable)
                                                                                               Indoor (40°C, 40%RH)                      CONDITIONS if available,
                                                                                                                                Sauna 70–90°C
                                                                                                                                                                        CONDITIONS    or   even  using
                                                                                                                                                                                                    CONDITIONS          artificialWater
                                                                                                                                                                                                                                      techniques
                                                                                                                                                                                                                                          40–42°C       aimed
                                                                                                 Indoor (40°C, 40%RH)                      Outdoor (variable)
                DURATION
                   60–90 MINS                 DURATION                 DURATION                  DURATION
                                                                                                                              DURATION   Indoor (40°C, 40%RH)
                                                                                                                                                                  heatersIndoorand      boiling
                                                                                                                                                                                (40°C, 40%RH)     water
                                                                                                                                                                                                    Indoor (40°C, 40%RH)at inducing         heat
                                                                                                                                                                                                                                    Sauna 70–90°C   adaptation
                                                                                                   DURATION
                                                                                                                               45–60 MINS, or
                                                60–90 MINS                60–90 MINS                60–90 MINS             intermittent for 30 MINS               to artificially create hot and                        are called       “heat acclimation”.
                                                                                                                                                                                                                                  DURATION
                                                                                                      60–90 MINS                            DURATION                       DURATION                   DURATION
                                                                                                                                               60–90 MINS         humid ambient
                                                                                                                                                                             60–90 MINS      conditions).
                                                                                                                                                                                                        60–90 MINS Although             notfor as
                                                                                                                                                                                                                                   45–60 MINS, or
                                                                                                                                                                                                                               intermittent         specific as
                                                                                                                                                                                                                                               30 MINS
                                                                                                                                                                                                                        exercise heat acclimatisation,
                                                                                                                                                                  It is also possible to use
                                                                                                                                                                                                                        heat acclimation can be
                                                                                                                                                                  passive heat acclimation
                                                                                                                                                                                                                        used before travelling
                                                                                                                                                                  techniques such as hot
           Source: Daanen, H. A. M., Racinais, S. & Périard,                                                                                                                                                            to a hot environment to
                                                                                                                                                                  water immersion or sauna
           J. D. Sports Med 48, 409–430 (2018).                                                                                                                                                                         reduce the time required for
                                                                                                                                                                  bathing for 30–40 minutes
                                                                                                                                                                                                                        acclimatisation upon arrival.
                                                                                                                                                                  pre- or post-training, but the

                                                                                                                                                                                                 BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020                9
When to heat acclimatise

          Figure 8: Examples of heat acclimatisation strategies,                                                                       HEAT
          depending on travel requirements                                                                                                                     Despite the benefits of heat
                                                           ACCLIMATISATION                                                                                   ACCLIMATION
                                                                                                                                                              acclimatisation, only 15% of
                                                                                       Natural Environment                                                     athletes
                                                                                                                                                               Artificial    participating in the 2015
                                                                                                                                                                         Environment
                                                                                      (outdoor/field training)                                               (indoor/laboratory
                                                                                                                                                               IAAF Worldtraining)
                                                                                                                                                                                Championships
           2 WEEKS’ ACCLIMATISATION BEFORE TRAVELLING

                                                                                                                          ACCLIMATISED
                                                                                                                                                               (Beijing) which were held in a hot
                                                                                                                          at time of competition
                                                                                                                                                               and humid environment, prepared
           ACCLIMATISATION IN ADVANCE + MAINTENANCE 1 SESSION/WEEK                                                                                             specifically by training in the heat
                                                                SELF-PACED                            CONSTANT                 CONTROLLED                  CONTROLLED                     PASSIVE
                                                                       EXERCISE                       WORK RATE                 INTENSITY                      prior to competition.
                                                                                                                                                          HYPERTHERMIA                    HEATING  While some
                                                                                                                          ACCLIMATISED
                                                                                                                          at time of competition               degree of heat acclimatisation
                                                                                                                                                               does occur by regular training
           PRE-ACCLIMATION + 1 WEEK ACCLIMATISATION UPON ARRIVAL
                                                                                                                                                               even in cool conditions, the most
                                                                                                                          ACCLIMATISED
                                                                                                                          at time of competition
                                                                                                                                                               effective method to obtain all
                                                                                                                                                               the heat adaptation benefits is
           2 WEEKS’ ACCLIMATISATION UPON ARRIVAL                       ACTIVITY                       ACTIVITY                       ACTIVITY                 ACTIVITY
                                                                                                                                                               to train in conditions    ACTIVITY  similar to
                                                                     Football, running, etc.        Walking at 6km/h,              Cycle ergometer at        Work +/– Rest to           Water immersion,
                                                                                                   running at 12km/h,             65% VO2max heart rate
                                                                                                                          ACCLIMATISED                         the upcoming competition (using
                                                                                                                                                              maintain  core             or sauna bathing
                                                                                                 cycle ergometer at 185 W at time of competition           temperature at 38.5°C
                                                                     CONDITIONS                                                       (e.g. 145 bpm)
                                                                                                                                                               either real or simulated
                                                                                                                                                                                      CONDITIONS        conditions).
                                                                       Outdoor (variable)         CONDITIONS                      CONDITIONS               CONDITIONS                     Water 40–42°C
                                                                     Indoor (40°C, 40%RH)           Outdoor (variable)
                                                                                                  Indoor (40°C, 40%RH)
                                                                                                                                  Indoor (40°C, 40%RH)         Travel
                                                                                                                                                           Indoor            to the competition
                                                                                                                                                                  (40°C, 40%RH)           Sauna 70–90°C should be

           -8        -7         -6         -5           -4           -3DURATION
                                                                             -2                  -1                                 Competition                planned to ensure               optimum heat
                                                                                                                                                                                        DURATION
                                                                         60–90 MINS                   DURATION                      DURATION                 DURATION
                                                   Number of weeks before competition                  60–90 MINS                     60–90 MINS               adaption
                                                                                                                                                               60–90  MINS       and intermittent
                                                                                                                                                                                     taking forinto
                                                                                                                                                                                         45–60 MINS, or
                                                                                                                                                                                                          account
                                                                                                                                                                                                    30 MINS
                                                                                                                                                               the competition schedule.

                                                                                                                                                                  BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020    10
How does hydration impact on performance?

          Figure 9: Dehydration level when competing in the heat                                                HEAT
                                                                                                                                     Heat dissipation relies on sweat
                                                               ACCLIMATISATION                                                           ACCLIMATION
                                                                                                                                     evaporation.           However, profuse sweating
                                                                      Natural Environment                                            may       leadEnvironment
                                                                                                                                           Artificial    to progressive dehydration
                                                                     (outdoor/field training)                                         if(indoor/laboratory
                                                                                                                                          fluids are not    training)
                                                                                                                                                                sufficiently replaced.
                                                                                                                                     Severe dehydration accelerates the rise
                                                                                                                                     in whole-body temperature and impairs
                                                                                                                                     prolonged exercise performance. This
                                                    SELF-PACED                    CONSTANT                 CONTROLLED               CONTROLLED                      PASSIVE
                                                     EXERCISE                     WORK RATE                 INTENSITY                reduction in performance
                                                                                                                                   HYPERTHERMIA                     HEATINGoccurs as
                                                                                                                                     dehydration negatively impacts the
                                                                                                                                     normal functioning of the heart by
                                                                                                                                     making it more difficult to maintain
                                                                                                                                     blood pressure and blood flow to the
                                                                                                                                     working muscles and skin (to lose heat).
                                                      ACTIVITY                     ACTIVITY                  ACTIVITY                    ACTIVITY a sufficient
                                                                                                                                     Therefore,                    ACTIVITYintake of fluids
                                                    Football, running, etc.        Walking at 6km/h,        Cycle ergometer at          Work +/– Rest to           Water immersion,
                                                                                  running at 12km/h,       65% VO2max heart rate     before, during and afterbathing
                                                                                                                                          maintain core            or sauna   exercise is
                                                                                cycle ergometer at 185 W                            temperature at 38.5°C
                                                    CONDITIONS                                                (e.g. 145 bpm)
                                                                                                                                     necessary for athletes      CONDITIONS to perform well
                                                      Outdoor (variable)         CONDITIONS                CONDITIONS                and stay safe when
                                                                                                                                    CONDITIONS                         competing
                                                                                                                                                                    Water 40–42°C    in hot
                                                    Indoor (40°C, 40%RH)           Outdoor (variable)
                                                                                                           Indoor (40°C, 40%RH)     Indoor (40°C, 40%RH)            Sauna 70–90°C
                                                                                 Indoor (40°C, 40%RH)                                and humid ambient conditions.
                                                     DURATION                                                                                                      DURATION

                                             Dehydration
                                                        60–90 MINS                 DURATION                 DURATION                    DURATION                   45–60 MINS, or
                                                                                     60–90 MINS                60–90 MINS              60–90 MINS         intermittent for 30 MINS

                                             can range between
                                             2–8%

                                                                                                                                          BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020   11
How much to drink

          Figure 10: What colour is your urine?                                                                   HEAT
                                                                                                      Drinking to satisfy thirst is                         maximum of about 1.2 L/h).
                                                                    ACCLIMATISATIONadequate for exercise lastingACCLIMATION                                 It is also important to recognise
                                                                           Natural Environment less than one to two hours inArtificial Environment           that hydration regimens should
                                                                         (outdoor/field training)
                                                                                                      cool environments. Planned(indoor/laboratory          nevertraining)
                                                                                                                                                                    result in significant over-
                                                                                                      drinking may enhance sporting                         hydration, as this can have
                                                          WELL HYDRATED                               performance during activities                         serious health consequences
                                                                                                      lasting more than 90 minutes,                         (so called “hyponatremia”,
                                                        SELF-PACED                      CONSTANT                CONTROLLED                  CONTROLLED                     PASSIVE
                                                           EXERCISE                    WORK RATE      particularly    during
                                                                                                                  INTENSITY        high-intensity
                                                                                                                                           HYPERTHERMIA     an imbalance   HEATING of the salts in
                                                  FAIRLY WELL HYDRATED                                exercise in the heat that elicits                     the body) that can be more
                                                                                                      high sweat rates (and when                            severe than dehydration and
                                                                                                      carbohydrate intake of 1 g/min                        even result in death. Simple
                                                               DEHYDRATED                             or more is desired). Individuals                      techniques such as measuring
                                                                                                      with high sweat rates and/or                          body mass before and after
                                                           ACTIVITY                      ACTIVITY                  ACTIVITY
                                                                                                      those concerned with exercise            ACTIVITY     exercise or   ACTIVITY
                                                                                                                                                                              evaluating urine
                                                        Football, running, etc.         Walking at 6km/h,         Cycle ergometer at          Work +/– Rest to           Water immersion,
                                                       VERY DEHYDRATED                  running at    performance
                                                                                                   12km/h,      65% VO should
                                                                                                                    2max
                                                                                                                            heart rate determine
                                                                                                                                               maintain     colour in the
                                                                                                                                                         core             or    morning
                                                                                                                                                                             sauna  bathing    (first
                                                                                     cycle ergometer at 185 W                               temperature at 38.5°C
                                                        CONDITIONS                                                  (e.g. 145 bpm)
                                                                                                      sweat rates under conditions                          void) canCONDITIONS
                                                                                                                                                                          help athletes assess
                                                          Outdoor (variable)          CONDITIONS
                                                        Indoor (40°C, 40%RH)            Outdoor (variable)        intensity, speed) CONDITIONS
                                                                                                      (exerciseCONDITIONS                   and             fluid losses       through sweating
                                                                                                                                                                           Water 40–42°C
                                                                                                                                                                           Sauna 70–90°C
                                                                                                                 Indoor (40°C, 40%RH)       Indoor (40°C, 40%RH)
                                                  SEVERELY DEHYDRATED
                                                          DURATION
                                                                                                      ambient conditions similar
                                                                                      Indoor (40°C, 40%RH)
                                                                                                                                                            and estimate hydration needs
                                                                                                      to that anticipated                                                DURATION
                                                            60–90 MINS                   DURATION                  DURATIONwhen DURATION                    and status.       It MINS,
                                                                                                                                                                          45–60   is ofor paramount
                                                                                           60–90 MINS
                                                                                                      competing, and tailor drinking
                                                                                                                     60–90 MINS                 60–90 MINS
                                                                                                                                                            importance that athletes
                                                                                                                                                                      intermittent for 30 MINS

                                                                                                      to prevent body mass losses                           establish their optimal personal
                                                                                                      exceeding 2–3% in general.                            drinking strategies during
                                                                                                                                                            training and well before arriving
                                                                                                      Individualised prescription of
                                                                                                                                                            at the competition.
                                                                                                      fluids must remain within the
                                                                                                      limits of how much fluid can
                                                                                                      be absorbed (i.e. typically a

                                                                                                                                               BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020        12
What to drink

           Figure 11: Hydration index (i.e. amount of water retained as                                                            HEAT
           compared to still water) of common beverages                                                                                                 Sodium (salt) supplementation during
                                                             ACCLIMATISATION                                                                              ACCLIMATION
                                                                                                                                                        exercise         lasting longer than one hour
                                    0.0         0.5              1.0          1.5
                                                                                         Natural Environment
                                                                                              2.0                                                       is Artificial
                                                                                                                                                            recommendedEnvironment for heavy and “salty”
                                                                                        (outdoor/field training)                                         (indoor/laboratory training)
                  Skimmed milk                                                                                                                          sweaters.          Sodium intake may be
                                                                                                                                                        increased before and after hot-weather
                    Full fat milk                                                                                                                       training and racing. Electrolyte tablets
                    Orange juice                                                                                                                        or some salt (a pinch of salt at a time)
                                                                       SELF-PACED                    CONSTANT                 CONTROLLED               CONTROLLED                     PASSIVE
                                                                        EXERCISE                     WORK RATE                 INTENSITY                may be used by athletes
                                                                                                                                                      HYPERTHERMIA                    HEATING      during training
                            Cola                                                                                                                        and competition by those who tolerate
                        Diet cola                                                                                                                       it. It is also advisable to include 30–60
                                                                                                                                                        g/h of carbohydrates to drinks for
                        Cold tea                                                                                                                        sporting performances lasting about
                             Tea                                                                                                                        one hour and up to 90 g/h for longer
                                                                         ACTIVITY                     ACTIVITY                  ACTIVITY                  ACTIVITY
                                                                                                                                                        events.                      ACTIVITY
                                                                                                                                                                      These recommendations                 can
                                                                       Football, running, etc.        Walking at 6km/h,        Cycle ergometer at        Work +/– Rest to           Water immersion,
                    Sports drink                                                                     running at 12km/h,       65% VO2max heart rate     be achieved throughsauna
                                                                                                                                                           maintain core             or    a bathing
                                                                                                                                                                                               combination of
                                                                                                   cycle ergometer at 185 W                            temperature at 38.5°C
                Sparkling water                                        CONDITIONS                                                (e.g. 145 bpm)
                                                                                                                                                        fluids and solid foods.   CONDITIONS   After training or
                                                                         Outdoor (variable)         CONDITIONS                CONDITIONS               CONDITIONS
                                                                       Indoor (40°C, 40%RH)           Outdoor (variable)                                competition in theWater        heat,      recovery drinks
                                                                                                                                                                                            40–42°C
                                                                                                                                                                                      Sauna 70–90°C
                      Still water                                                                                             Indoor (40°C, 40%RH)     Indoor (40°C, 40%RH)
                                                                        DURATION
                                                                                                    Indoor (40°C, 40%RH)
                                                                                                                                                        should include sodium, carbohydrate
                                                                                                                                                        and                         DURATION
                                                                                                                                                                if necessary, protein
                           Lager                                           60–90 MINS                 DURATION                 DURATION                  DURATION                    45–60 MINS, to or optimise
                                                                                                        60–90 MINS                60–90 MINS
                                                                                                                                                        recovery. The preferred method of
                                                                                                                                                           60–90 MINS            intermittent for 30 MINS
                          Coffee
                                                                                                                                                        rehydration is through the consumption
                                                                                                                                                        of fluids with foods, including salty food.
             Source: Maughan, R. J. et al. Am J Clin Nutr 103,
             717–723 (2016).

                                                                                                                                                              BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020      13
What about pre- and per-cooling?

          Figure 12: An example of a cooling vest that can                                                     HEAT
          be used during the warm-up                                                                      Before the start of                                 sunglasses in a dark tint
                                                                ACCLIMATISATION competition, it is advisable                                 ACCLIMATION      (i.e. Category 3) and their skin
                                                                       Natural Environment                to minimise unnecessaryArtificial Environment        by using non-greasy sun-
                                                                     (outdoor/field training)                                               (indoor/laboratory training)
                                                                                                          heat exposure and heat              gain.           screen (water-based sun
                                                                                                                                                              screen should be preferred
                                                                                                          Athletes should therefore
                                                                                                                                                              to oil-based sun-screen that
                                                                                                          warm up in the shade if
                                                                                                                                                              may affect sweating).
                                                    SELF-PACED                      CONSTANT possible.        CONTROLLED Athletes should CONTROLLED                       PASSIVE
                                                       EXERCISE                    WORK RATE                    INTENSITY               HYPERTHERMIA                      HEATING
                                                                                                          consider external (ice vests,                       Light-coloured clothing can
                                                                                                          cold towels, or fanning) and                        also minimise the effect of
                                                                                                          internal (cold fluid or ice                         the sun’s radiation and should
                                                                                                          slurry ingestion) pre-cooling                       therefore be preferred, but
                                                                                                          methods, or a combination                           clothing should not impair
                                                       ACTIVITY                      ACTIVITY             of both.
                                                                                                                 ACTIVITY                    ACTIVITY sweat evaporation. ACTIVITY             Self-
                                                    Football, running, etc.         Walking at 6km/h,
                                                                                    running at 12km/h,
                                                                                                                Cycle ergometer at          Work +/– Rest to
                                                                                                                                              maintain core
                                                                                                                                                              dousingor with          water or other
                                                                                                                                                                        Water immersion,
                                                                                                                                                                            sauna bathing
                                                                                 cycle ergometer at 185 W External
                                                                                                               65% VO pre-cooling
                                                                                                                          heart rate   during
                                                                                                                                         temperature at 38.5°Ccooling techniques that are
                                                                                                                 2max

                                                    CONDITIONS                                                    (e.g. 145 bpm)
                                                                                                                                                                      CONDITIONS
                                                      Outdoor (variable)          CONDITIONS warm-up           CONDITIONS
                                                                                                                         such as with
                                                                                                                                         CONDITIONS           commonly           adopted are less
                                                                                                                                                                          Water 40–42°C
                                                    Indoor (40°C, 40%RH)            Outdoor (variable)    commercially           availableIndoor
                                                                                                                                             ice-(40°C, 40%RH)evidence-based
                                                                                  Indoor (40°C, 40%RH)
                                                                                                               Indoor (40°C, 40%RH)                                       Sauna 70–90°C
                                                                                                                                                                                          but may offer
                                                      DURATION                                            cooling vests can provide
                                                                                                                                                              some psychological
                                                                                                                                                                        DURATION               benefit.
                                                        60–90 MINS                   DURATION effective          DURATION
                                                                                                                        cooling without     DURATION                     45–60 MINS, or
                                                                                       60–90 MINS                  60–90 MINS                 60–90 MINS             intermittent for 30 MINS
                                                                                                          affecting optimal muscle                            Any cooling method should
                                                                                                          temperature and function.                           be tested and individualised
                                                                                                                                                              during training and not in
                                                                                                          During competition, athletes
                                                                                                                                                              competition, to minimise
                                                                                                          should also protect their eyes
                                                                                                                                                              disruption to the athlete.
                                                                                                          by wearing UV-ray blocking

                                                                                                                                              BEAT THE HEAT DURING THE OLYMPIC GAMES TOKYO 2020           14
To find out more, visit
www.olympic.org/athlete365/well-being/beat-the-heat
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