Périard et al. 2021, Exercise under heat stress: thermoregulation, hydration and performance

This 106-page narrative review in Physiological Reviews (Vol. 101, pp. 1873–1979) synthesises the full evidence base on thermoregulation, fluid homeostasis and performance during exercise in the heat. It covers the mechanisms of hyperthermia-driven fatigue, cardiovascular strain and haemodynamic compromise, sex differences in sweat rate and cutaneous vasodilation (with body size, fitness and acclimation identified as major confounders), the dehydration threshold at which performance and cardiovascular strain worsen, and evidence-based mitigation strategies including pre-cooling and heat acclimation. Strong evidence.