Highlights
- •Acute physiological responses to cold exposure include cutaneous vasoconstriction and shivering thermogenesis which, respectively, decrease heat loss and increase metabolic heat production.
- •Anthropometry, sex, race, fitness, and thermoregulatory fatigue impact vasoconstriction, shivering, and thermal balance.
- •Three primary patterns of cold acclimatization have been observed, a) habituation, b) metabolic adjustment, and c) insulative adjustment.
- •The pattern of acclimatization is dependent on changes in skin and core temperature and the exposure duration.
Abstract
Cold exposure in humans causes specific acute and chronic physiological responses.
This paper will review both the acute and long-term physiological responses and external
factors that impact these physiological responses. Acute physiological responses to
cold exposure include cutaneous vasoconstriction and shivering thermogenesis which,
respectively, decrease heat loss and increase metabolic heat production. Vasoconstriction
is elicited through reflex and local cooling. In combination, vasoconstriction and
shivering operate to maintain thermal balance when the body is losing heat. Factors
(anthropometry, sex, race, fitness, thermoregulatory fatigue) that influence the acute
physiological responses to cold exposure are also reviewed. The physiological responses
to chronic cold exposure, also known as cold acclimation/acclimatization, are also
presented. Three primary patterns of cold acclimatization have been observed, a) habituation,
b) metabolic adjustment, and c) insulative adjustment. Habituation is characterized
by physiological adjustments in which the response is attenuated compared to an unacclimatized
state. Metabolic acclimatization is characterized by an increased thermogenesis, whereas
insulative acclimatization is characterized by enhancing the mechanisms that conserve
body heat. The pattern of acclimatization is dependent on changes in skin and core
temperature and the exposure duration.
Keywords
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References
- Human physiological responses to a standardized cold stress as modified by physical fitness.J. Appl. Physiol. 1958; 13: 226-230
- Pharmacological blockade of the cold receptor TRPM8 attenuates autonomic and behavioral cold defenses and decreases deep body temperature.J. Neurosci. 2012; 32: 2086-2099
- Metabolic and thermal response of Eskimos during muscular exertion in the cold.J. Appl. Physiol. 1963; 18: 613-618
- Metabolic and thermal response to a moderate cold exposure in nomadic Lapps.J. Appl. Physiol. 1960; 15: 649-653
- Alterations in resting oxygen consumption in women exposed to 10 days of cold air.FASEB J. 1991; 5: A393
- Skin vascular reactivity in healthy subjects — influence of hormonal status.J. Appl. Physiol. 1993; 74: 727-732
- Changes in skin blood flow during the menstrual cycle: the influence of the menstrual cycle on the peripheral circulation in healthy female volunteers.Clin. Sci. 1990; 78: 527-532
- Metabolic and energy balances of men in a cold environment.in: Horvath S.M. Cold Injury. Capital City Press, Montpelier, VT1958: 317-338
- Relative intensity of muscular contraction during shivering.J. Appl. Physiol. 1992; 72: 2336-2342
- The physiological and subjective responses to repeated cold water immersion in a group of 10–12 year olds.J. Sport Sci. Med. 2012; 11: 779
- Heat debt as an index for cold adaptation in men.J. Appl. Physiol. 1987; 62: 1627-1634
- Influence of localized auxiliary heating on hand comfort during cold exposure.J. Appl. Physiol. 1998; 85: 2054-2065
- Effect of cold face stimulation on cerebral blood flow in humans.Brain Res. Bull. 2003; 61: 81-86
- Metabolic response to cold air in men and women in relation to total body fat content.J. Appl. Physiol. 1963; 18: 603-612
- The metabolic rate and heat loss of fat and thin men in heat balance in cold and warm water.J. Physiol. 1960; 154: 329-344
- Eighty-four hours of sustained operations alter thermoregulation during cold exposure.Med. Sci. Sports Exerc. 2003; 35: 175-181
- Thermoregulation during cold exposure after several days of exhaustive exercise.J. Appl. Physiol. 2001; 90: 939-946
- Prevention of cold injuries during exercise.Med. Sci. Sports Exerc. 2006; 38: 2012-2029
- Thermoregulation during cold exposure: effects of prior exercise.J. Appl. Physiol. 1999; 87: 247-252
- Human thermoregulatory responses during serial cold-water immersions.J. Appl. Physiol. 1998; 85: 204-209
- Reflex control of cutaneous vasoconstrictor system is reset by exogenous female reproductive hormones.J. Appl. Physiol. 1999; 87: 381-385
- Mechanisms and modifiers of reflex induced cutaneous vasodilation and vasoconstriction in humans.J. Appl. Physiol. 2010; 109: 1221-1228
- Silent α2c-adrenergic receptors enable cold-induced vasoconstriction in cutaneous arteries.Am. J. Physiol. Heart Circ. Physiol. 2000; 278: H1075-H1083
- Regulation of alpha(2)-adrenoceptors in human vascular smooth muscle cells.Am. J. Physiol. Heart Circ. Physiol. 2004; 286: 59-67
- Metabolic responses to submaximal exercise in three water temperatures.J. Appl. Physiol. 1967; 22: 628-632
- Thermal regulation during water immersion.J. Appl. Physiol. 1966; 21: 1577-1585
- Identification and importance of brown adipose tissue in adult humans.N. Engl. J. Med. 2009; 360: 1509-1517
- Finger cold-induced vasodilation during mild hypothermia, hyperthemia and at thermoneutrality.Aviat. Space Environ. Med. 1999; 70: 1206-1210
- The effect of body temperature on the hunting response of the middle finger skin temperature.Eur. J. Appl. Physiol. 1997; 76: 538-543
- Chamber cold acclimatization in man.J. Appl. Physiol. 1961; 16: 1011-1015
- Impaired defense of core temperature in aged humans during mild cold stress.Am. J. Physiol. 2007; 292: R103-R108
- Cyclic intramuscular temperature fluctuations in the human forearm during cold-water immersion.Eur. J. Appl. Physiol. 1991; 63: 188-193
- Tissue temperature profile in the human forearm during thermal stress at thermal stability.J. Appl. Physiol. 1991; 71: 1973-1978
- Estrogen increases smooth muscle expression of a2c-adrenoceptors and cold-induced constriction of cutaneous arteries.Am. J. Physiol.: Heart. Circ. Physiol. 2007; 293: H1955-H1961
- Thermal and metabolic responses of Arctic Indians to moderate cold exposure at the end of winter.J. Appl. Physiol. 1960; 15: 659-661
- Reactions to hand cooling in workers occupationally exposed to cold.Scand. J. Work Environ. Health. 1980; 6: 58-65
- Response to rest and exercise in the cold: effects of age and aerobic fitness.J. Appl. Physiol. 1994; 76: 72-78
- Relative contribution of core and cutaneous temperatures to thermal comfort and autonomic responses in humans.J. Appl. Physiol. 1999; 86: 1588-1593
- Age-related thermoregulatory differences during core cooling in humans.Am. J. Physiol. 2000; 279: R349-R354
- Mechanisms of heat exchange: Biophysics and physiology.in: Fregly M.J. Blatteis C.M. Handbook of Physiology: Environmental Physiology. American Physiological Society, Bethesda, MD1996: 45-84
- Hypoglycaemia, hypothermia and shivering in man.Clin. Sci. (Colch). 1981; 61: 463-469
- The influence of gender and menstrual phase on thermosensitivity during cold water immersion.Aviat. Space Environ. Med. 2000; 71: 715-722
- Influence of gender and menstrual cycle on a cold air tolerance test and its relationship to thermosensitivity.Undersea Hyperb. Med. 2000; 27: 75-81
- Human adaptation to repeated cold immersions.J. Physiol. (Lond.). 1988; 396: 349-363
- Shivering intensity in humans during immersion in cold water.J. Physiol. (Lond.). 1979; 277: 48
- Lean long distance swimmers.J. Royal Navy Med. Serv. 1980; 66: 26-30
- Thermoregulatory responses to cold transients: effects of menstrual cycle in resting women.J. Appl. Physiol. 1998; 85: 543-553
- Biophysics of heat transfer and clothing considerations.in: Pandolf K.B. Sawka M.N. Gonzalez R.R. Human Performance Physiology and Environmental Medicine at Terrestrial Extremes. Benchmark, Indianapolis, IN1988: 45-95
- Raynaud's phenomenon.Am. Fam. Physician. 1990; 41: 134-142
- Thermal and metabolic responses of the alacaluf Indians to moderate cold exposure.WADC Tech. Rep. U. S. Air Force Wright Air Dev. Cent. Day. Ohio. 1960; 60-633: 1-44
- Thermal and metabolic responses of the Australian aborigine exposed to moderate cold in summer.J. Appl. Physiol. 1959; 14: 605-615
- Autonomic nervous system and adrenal response to cold in man at Antarctica.Wilderness Environ. Med. 2005; 16: 81-91
- Thermal and metabolic responses of coastal Eskimos during a cold night.J. Appl. Physiol. 1962; 17: 953-960
- Relation of changing levels of physical fitness to human cold acclimatization.J. Appl. Physiol. 1961; 16: 226-230
- Human cold air habituation is independent of thyroxine and thyrotropin.J. Appl. Physiol. 1992; 72: 2134-2139
- Terrestrial animals in cold: Exploratory studies of primitive man.in: Handbook of physiology, Section 4. 1964: 405-412
- Comparison of coastal Eskimos and Kalahari bushmen.Fed. Proc. 1963; 22: 843-845
- Physiology of cold water immersion: a comparison of cold water acclimatised and no-cold water acclimatised participants during static and dynamic immersions.Br. J. Sports Med. 2011; 45e1
- Aging and the control of human skin blood flow.Front. Biosci. 2010; 15: 718-739
- Pattern of cold adaptation in women divers of Korea (ama).Fed. Proc. 1973; 32: 1614-1622
- Thermal considerations.in: Shilling C.W. Carlston C.B. Mathias R.A. The Physican's Guide to Diving Medicine. Plenum Press, New York1984: 153-178
- Peripheral blood flow and heat flux of Korean women divers.Fed. Proc. 1969; 28: 1143-1148
- Metabolism and temperature of Arctic Indian men during a cold night.J. Appl. Physiol. 1960; 15: 635-644
- Changes in thermal homeostasis in humans due to repeated cold water immersions.Pflugers Arch. 1996; 432: 368-372
- Change in sympathetic activity, cardiovascular functions and plasma hormone concentrations due to cold water immersion in men.Eur. J. Appl. Physiol. 1996; 74: 148-152
- Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone.Am. J. Physiol. Heart Circ. Physiol. 2009; 296: H1868-H1877
- Mechanism of vasoconstriction with direct skin cooling in humans.Am. J. Physiol. Heart Circ. Physiol. 2007; 292: 1690-1691
- Changes in body temperature and basal metabolic rate of the ama.J. Appl. Physiol. 1963; 18: 483-488
- The effect of repeated daily exposure to cold and of improved physical fitness on the metabolic and vascular response to cold air.J. Physiol. Lond. 1961; 157: 209-220
- Reflex peripheral vasoconstriction is diminished in older men.J. Appl. Physiol. 1996; 80: 512-515
- Enhancement of the finger cold-induced vasodilation response with exercise training.Eur. J. Appl. Physiol. 2010; 109: 133-140
- Temperature regulation during rest and exercise in the cold in premenarcheal and menarcheal girls.J. Appl. Physiol. 2004; 96: 1393-1398
- Effect of continuous cold exposure on nocturnal body temperatures of man.J. Appl. Physiol. 1959; 14: 43-45
- Cold acclimation recruits human brown fat and increases nonshivering thermogenesis.J. Clin. Invest. 2013; 123: 3395-3403
- Human acclimatization to cold water immersion.Arch. Environ. Health. 1967; 15: 568-579
- Tolerance of Gaspé fishermen to cold water.J. Appl. Physiol. 1960; 15: 1031-1034
- Factors affecting cold acclimation and thermogenesis in man.Med. Sci. Sports Exerc. 1988; 20: S193-S196
- Seasonal variation in basal metabolic rates among the Yakut (Sakha) of Northeastern Siberia.Am. J. Hum. Biol. 2014; 26: 437-445
- Climatic influences on basal metabolic rates among circumpolar populations.Am. J. Hum. Biol. 2002; 14: 609-620
- Habituation of thermal sensations, skin temperatures, and norepinephrine in men exposed to cold air.J. Appl. Physiol. 2001; 90: 1211-1218
- Observations upon the reactions of the vessels of the human skin to cold.Heart. 1930; 15: 177-208
- Neural regulation of vascular tone and cold induced vasoconstriction in human finger skin.J. Auton. Nerv. Syst. 1990; 30: 169-174
- Autonomic nervous function during whole-body cold exposure before and after cold acclimation.Aviat. Space Environ. Med. 2008; 79: 875-882
- Thermoregulatory, metabolic and sympathoadrenal responses to repeated brief exposure to cold.Scand. J. Clin. Lab. Invest. 1998; 58: 537-546
- Cold-activated brown adipose tissue in healthy men.N. Engl. J. Med. 2009; 360: 1500-1508
- Physiological characteristics of cold acclimatization in man.Int. J. Biometeorol. 1981; 25: 191-198
- Thermal adjustment to cold-water exposure in resting men and women.J. Appl. Physiol. 1984; 56: 1565-1571
- Thermal adjustment to cold-water exposure in exercising men and women.J. Appl. Physiol. 1984; 56: 1572-1577
- Respiratory and cardiovascular responses to cold stress following repeated cold water immersion.Undersea Biomed. Res. 1988; 15: 165-178
- Cold vasodilatation and cold acclimatization in the hands of British fish filleters.J. Appl. Physiol. 1962; 17: 444-448
- Relationship between seasonal cold acclimatization and mtDNA haplogroup in Japanese.J. Physiol. Anthropol. 2012; 31: 22
- Role of core temperature as a stimulus for cold acclimation during repeated immersion in 20 °C water.J. Appl. Physiol. 2000; 89: 242-250
- Preferred temperature of the elderly after cold and heat exposures determined by individual self-selection of air temperature.J. Therm. Biol. 1993; 18: 349-353
- Time course of deacclimatization to cold water immersion in Korean women divers.J. Appl. Physiol. 1983; 54: 1708-1716
- Effect of hypoglycemia on thermoregulatory responses.J. Appl. Physiol. 1996; 80: 1021-1032
- Accidental hypothermia in walkers, climbers, and campers: report to the medical commission on accident prevention.Br. Med. J. 1966; 1: 123-129
- Cold stress and muscular exercise, with special reference to accidential hypothermia.Br. Med. J. 1967; 2: 333-337
- Hormone response of normal and intermittent cold-preadapted humans to continuous cold.J. Appl. Physiol. 1982; 53: 610-616
- Physical regulation of temperature in Eskimos.J. Appl. Physiol. 1962; 17: 326-332
- Basal metabolism of the Eskimo.J. Nutr. 1952; 48: 359-368
- High incidence of metabolically active brown adipose tissue in healthy adult humans: effects of cold exposure and adiposity.Diabetes. 2009; 58: 1526-1531
- Hypothermic general cold adaptation induced by local cold acclimation.Eur. J. Appl. Physiol. Occup. Physiol. 1996; 73: 237-244
- Physiological systems and their responses to conditions of heat and cold.in: Farrell P.A. Joyner M.J. Caiozzo V.J. ACSM's Advanced Exercise Physiology. Lippincott Williams & Wilkins, Philadelphia2012: 567-602
- Cold adaptation in Australian aborigines.J. Appl. Physiol. 1958; 13: 211-218
- Effects of repeated short-term cold exposures on cold induced thermogenesis of women.Int. J. Biometeorol. 1989; 33: 222-226
- Acclimatization to cold in man induced by frequent scuba diving in cold water.J. Appl. Physiol. 1968; 24: 177-181
- Cooling rates of young people swimming in cold water.J. Appl. Physiol. 1973; 35: 371-375
- Thermoregulation during rest and exercise in the cold in pre- and early pubescent boys and in young men.J. Appl. Physiol. 1992; 72: 1589-1594
- Effect of cold exposure on older humans.Int. J. Sports Med. 2002; 23: 86-92
- Basal metabolic rate in the Yakut (Sakha) of Siberia.Am. J. Hum. Biol. 2005; 17: 155-172
- Skin temperature of Australian aboriginals under varying atmospheric conditions.Aust. J. Exp. Med. Sci. 1938; 16: 1-18
- Nonnoradrenergic mechanism of reflex cutaneous vasoconstriction in men.Am. J. Physiol. 2001; 280: H1496-H1504
- Sympathetic nonnoradrenergic cutaneous vasoconstriction in women is associated with reproductive hormone status.Am. J. Physiol. Heart Circ. Physiol. 2002; 282: H264-H272
- Neuropeptide Y antagonism reduces reflex cutaneous vasoconstriction in humans.Am. J. Physiol. 2004; 287: H1404-H1409
- Preferred room temperature of young vs. aged males: the influence of thermal sensation, thermal comfort, and affect.J. Gerontol. A Biol. Sci. Med. Sci. 1995; 50: 216-221
- Altered neurotransmitter control of reflex vasoconstriction in aged human skin.J. Physiol. 2004; 558: 697-704
- Attenuated noradrenergic sensitivity during local cooling in aged human skin.J. Physiol. 2005; 564: 313-319
- Wet-cold exposure and hypothermia: thermal and metabolic responses to prolonged exercise in man.J. Appl. Physiol. 1996; 81: 1128-1137
- Cold-induced cutaneous vasoconstriction is mediated by rho kinase in vivo in human skin.Am. J. Physiol. Heart Circ. Physiol. 2007; 292: H1700-H1705
- Rho kinase-mediated local cold-induced cutaneous vasoconstriction is augmented in aged human skin.Am. J. Physiol. Heart Circ. Physiol. 2007; 293: H30-H36
- Altered mechanisms of thermoregulatory vasoconstriction in aged human skin.Exerc. Sport Sci. Rev. 2008; 36: 122-127
- Habituation of the metabolic and ventilatory responses to cold-water immersion in humans.J. Therm. Biol. 2013; 38: 24-31
- Human thermoregulatory responses to acute cold stress with special reference to water immersion.in: Fregley M.J. Blatteis C.M. Handbook of Physiology: Environmental Physiology. American Physiological Society, Bethesda, MD1996: 379-418
- Superficial shell insulation in resting and exercising men in cold water.J. Appl. Physiol. 1982; 52: 1557-1564
- Functional brown adipose tissue in healthy adults.N. Engl. J. Med. 2009; 360: 1518-1525
- TRP ion channels in thermosensation, thermoregulation and metabolism.Temperature. 2015; 2: 178-187
- Homeostatic responses to prolonged cold exposure: human cold acclimatization.in: Fregly M.J. Blatteis C.M. Handbook of Physiology: Environmental Physiology. American Physiological Society, Bethesda, MD1996: 419-438
- Aging and human cold tolerance.Exp. Aging Res. 1997; 23: 45-67
- Exertional fatigue, sleep loss, and negative energy balance increase susceptibility to hypothermia.J. Appl. Physiol. 1998; 85: 1210-1217
- Human thermoregulatory responses to cold air are altered by repeated cold water immersion.J. Appl. Physiol. 1986; 60: 1542-1548
- Human vascular fluid responses to cold stress are not altered by cold acclimation.Undersea Biomed. Res. 1987; 14: 215-228
Article info
Publication history
Published online: February 21, 2016
Accepted:
February 17,
2016
Received in revised form:
February 3,
2016
Received:
October 26,
2015
Identification
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Published by Elsevier B.V.
