Does the temperature of water ingested during exertional-heat stress influence gastrointestinal injury, symptoms, and systemic inflammatory profile?

Rhiannon M.J. Snipe, Ricardo Da Costa

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40 Citations (Scopus)


Objectives: The study aimed to determine the effects of temperature of ingested water during exertional-heat stress on gastrointestinal injury, symptoms and systemic inflammatory responses. Design: Randomised cross-over study. Methods: Twelve endurance runners completed 2 h running at 60% v˙O2max in 35 °C ambient temperature on three separate occasions, consuming 250 ± 40 mL water before and every 15 min during running at either 0.4 ± 0.4 °C (COLD), 7.3 ± 0.8 °C (COOL), or 22.1 ± 1.2 °C (TEMP). Rectal temperature and gastrointestinal symptoms were recorded every 10 min during exercise. Blood was collected pre, immediately and 1 h post-exercise to determine plasma intestinal fatty-acid binding protein (I-FABP), cortisol, and inflammatory cytokine concentrations. Results: Compared to TEMP, COLD and COOL blunted the rise in rectal temperature (2.0 ± 0.5 °C vs. 1.6 ± 0.4 °C and 1.7 ± 0.4 °C, respectively; trial × time, p = 0.033). I-FABP increased post-exercise (419%, p < 0.001), with a trend for reduced I-FABP on COLD and COOL (mean reduction 460 pg mL−1 and 430 pg mL−1, respectively), compared to TEMP (p = 0.066). No differences were observed between trials for gastrointestinal symptoms, albeit a trend for increased upper-gastrointestinal symptoms on TEMP (p = 0.087) compared to COLD and COOL was observed. IL-6, IL-1β, IL-8, IL-10 and IL-1ra increased post-exercise (p < 0.05); however no differences were observed between trials. Conclusions: COLD and COOL water ingestion during exertional-heat stress ameliorates thermoregulatory strain compared to TEMP. However, this appears to have no effect on cytokine profile and minimal effect on intestinal epithelial injury and gastrointestinal symptoms.

Original languageEnglish
Pages (from-to)771-776
Number of pages6
JournalJournal of Science and Medicine in Sport
Issue number8
Publication statusPublished - 1 Aug 2018


  • Gastrointestinal symptoms
  • Heat
  • Intestinal fatty acid binding protein
  • Running
  • Thermoregulation
  • Water

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