Caffeine and heat have additive but not interactive effects on physiologic strain: A factorial experiment

This study tested the interactive effects of heat and caffeine on exercise-induced physiological strain by using a 2x2 within-subjects factorial design. Thirty-five physically fit Caucasians underwent a bout of exercise under four conditions wherein ambient conditions (heat vs no heat) and caffeine (placebo vs caffeine; double-blinded) were manipulated. Exercise consisted of a 60-min walk and 5-min step/squat test while wearing weighted backpack. Primary outcomes include measures of physiologic strain (Core temperature [T_r] and heart rate [HR]). Secondary measures included blood pressure, markers of sweat loss, and creatine kinase (CK). Repeated measures models were created to evaluate the individual and combined effects of heat and caffeine. Key results indicated that heat and caffeine significantly increased T_r and HR after walking and stair-stepping. No significant heat by caffeine interactions were detected, and caffeine's main effects were relatively low (≤0.17 °C for T_r and ≤6.6 bpm for HR). Of note, heat and caffeine exhibited opposite effects on blood pressure: caffeine increased both systolic and diastolic blood pressure (by 6-7 mmHg) and heat decreased them (by 4-6 mm Hg; ps < 0.05). In summary, heat and caffeine affected physiologic strain during exercise but exhibited no synergistic effects. In contrast, neither factor affected muscle damage. Clinical implications for heat illness risk in the military are discussed.