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The effects of menthol on exercise performance and thermal sensation: A meta-analysis

Published:December 07, 2018DOI:https://doi.org/10.1016/j.jsams.2018.12.002

      Abstract

      Objectives

      Menthol is an organic compound with non-thermal cooling properties that has been shown to relieve thermal strain associated with exercise in the heat; however, its effects on performance have not been systematically analysed. The aims were to determine the effects of menthol applied (1) internally and (2) externally on exercise performance and thermal sensation.

      Design

      Meta-analysis

      Methods

      A search was performed using various databases in August 2018. The studies were screened using search criteria for eligibility. Thirteen peer-reviewed articles were identified for inclusion in a primary analysis on the effect of menthol on exercise performance; subsequently eleven of these articles were included in a secondary analysis on the effect of menthol on thermal sensation during exercise. A sub-analysis examining the application method was also performed.

      Results

      Menthol improved overall exercise performance (Hedges’ g = 0.33, 95% CI −0.00, 0.65 P = 0.05), demonstrating greater effects when applied internally (Hedges’ g = 0.40, 95% CI 0.04, 0.76, P = 0.03). Thermal sensation was also lowered overall across all studies (Hedges’ g = −0.54, 95% CI −0.67, −0.42, P < 0.001).

      Conclusions

      Exercise performance can be improved by application of non-thermally cooling menthol, which also reduces perceptual measures of thermal sensation. Internal application appears to be the best strategy to improve performance.

      Abbreviations:

      NS (non significant), PO (power output), Pt (point (on thermal sensation scale)), RPE (rating of perceived exertion), TRP (transient receptor potential), TS (thermal sensation), TT (time-trial), TTE (time-to-exhaustion), Wmax (maximal power output achieved in incremental ramp test)

      Keywords

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      References

        • Eccles R.
        Menthol and related cooling compounds.
        J Pharm Pharmacol. 1994; 46: 618-630https://doi.org/10.1111/j. 2042-7158.1994.tb03871.x
        • McKemy D.D.
        • Neuhausser W.M.
        • Julius D.
        Identification of a cold receptor reveals a general role for TRP channels in thermosensation.
        Nature. 2002; 416: 52-58https://doi.org/10.1038/nature719
        • Peier A.M.
        • Moqrich A.
        • Hergarden A.C.
        • et al.
        A TRP channel that senses cold stimuli and menthol.
        Cell. 2002; 108: 705-715https://doi.org/10.1016/S0092-8674(02)00652-9
        • Andersen H.H.
        • Olsen R.V.
        • Moller H.G.
        • et al.
        A review of topical high-concentration L-menthol as a translational model of cold allodynia and hyperalgesia.
        Eur J Pain. 2014; 18: 315-325https://doi.org/10.1002/j.1532-2149.2013.00380.x
        • Johnson C.D.
        • Melanaphy D.
        • Purse A.
        • et al.
        Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone.
        Am J Physiol Heart Circ Physiol. 2009; 296: H1868-H1877https://doi.org/10.1152/ajpheart.01112.2008
        • Watson H.
        • Hems R.
        • Rowsell D.
        • et al.
        New compounds with the menthol cooling effect.
        J Soc Cosmet Chem. 1978; 29: 185-200
        • Eccles R.
        • Griffiths D.H.
        • Newton C.G.
        • et al.
        The effects of D and L isomers of menthol upon nasal sensation of airflow.
        J Laryngol Otol. 1988; 102: 506-508
        • Karashima Y.
        • Damann N.
        • Prenen J.
        • et al.
        Bimodal action of menthol on the transient receptor potential channel TRPA1.
        J Neurosci. 2007; 27: 9874-9884https://doi.org/10.1523/JNEUROSCI.2221-07.2007
        • Galloway S.D.
        • Maughan R.J.
        Effects of ambient temperature on the capacity to perform prolonged cycle exercise in man.
        Med Sci Sports Exerc. 1997; 29: 1240-1249https://doi.org/10.1097/00005768-199709000-00018
        • Tatterson A.J.
        • Hahn A.G.
        • Martini D.T.
        • et al.
        Effects of heat stress on physiological responses and exercise performance in elite cyclists.
        J Sci Med Sport. 2000; 3: 186-193https://doi.org/10.1016/S1440-2440(00)80080-8
        • Vanden Hoek T.L.
        • Kasza K.E.
        • Beiser D.G.
        • et al.
        Induced hypothermia by central venous infusion: saline ice slurry versus chilled saline.
        Crit Care Med. 2004; 32: S425-S431https://doi.org/10.1097/01.CCM.0000134259.59793.B8
        • Siegel R.
        • Maté J.
        • Brearley M.B.
        • et al.
        Ice slurry ingestion increases core temperature capacity and running time in the heat.
        Med Sci Sports Exerc. 2010; 42: 717-725https://doi.org/10.1249/MSS.0b013e3181bf257a
        • Ross M.L.R.
        • Garvican L.A.
        • Jeacocke N.A.
        • et al.
        Novel precooling strategy enhances time trial cycling in the heat.
        Med Sci Sports Exerc. 2011; 43: 123-133https://doi.org/10.1249/MSS.0b013e3181e93210
        • Marino F.
        • Booth J.
        Whole body cooling by immersion in water at moderate temperatures.
        J Sci Med Sport. 1998; 1: 73-82https://doi.org/10.1016/S1440-2440(98)80015-7
        • Armada-da-Silva P.A.S.
        • Woods J.
        • Jones D.A.
        The effect of passive heating and face cooling on perceived exertion during exercise in the heat.
        Eur J Appl Physiol. 2004; 91: 563-571https://doi.org/10.1007/s00421-003-1006-0
        • Arngrïmsson S.
        • Petitt D.
        • Stueck M.
        • et al.
        Cooling vest worn during active warm-up improves 5-km run performance in the heat.
        J Appl Physiol. 2007; 292: 167-175https://doi.org/10.1152/japplphysiol.00979.2003
        • Flouris A.D.
        • Schlader Z.J.
        Human behavioral thermoregulation during exercise in the heat.
        Scand J Med Sci Sports. 2015; 25: 52-64https://doi.org/10.1111/sms.12349
        • Schlader Z.J.
        • Simmons S.E.
        • Stannard S.R.
        • et al.
        The independent roles of temperature and thermal perception in the control of human thermoregulatory behavior.
        Physiol Behav. 2011; 103: 217-224https://doi.org/10.1016/j.physbeh.2011.02.002
        • Stevens C.J.
        • Best R.
        Menthol: a fresh ergogenic aid for athletic performance.
        Sport Med. 2016; : 1-8https://doi.org/10.1007/s40279-016-0652-4
        • Moher D.
        • Shamseer L.
        • Clarke M.
        • et al.
        Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.
        Syst Rev. 2015; 4: 1https://doi.org/10.1186/2046-4053-4-1
        • Higgins J.P.
        • Altman D.
        Assessing risk of bias in included studies.
        in: Higgins J.P. Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series. Wiley, Chichester2008
        • Rinaldi K.
        • Trong T.T.
        • Riera F.
        • et al.
        Immersion with menthol improves recovery between 2 cycling exercises in hot and humid environment.
        Appl Physiol Nutr Metab. 2018; 43: 902-908https://doi.org/10.1139/apnm-2017-0525
        • Higgins J.P.
        • Altman D.
        Imputing standard deviations for changes from baseline.
        in: Higgins J.P. Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series. Wiley, Chichester2008
        • Gagge A.P.
        • Stolwijk J.A.
        • Hardy J.D.
        Comfort and thermal sensations and associated physiological responses at various ambient temperatures.
        Environ Res. 1967; 1: 1-20https://doi.org/10.1016/0013-9351(67)90002-3
        • Zhang H.
        • Huizenga C.
        • Arenas E.
        • et al.
        Thermal sensation and comfort in transient non-uniform thermal environments.
        Eur J Appl Physiol. 2004; 92: 728-733https://doi.org/10.1007/s00421-004-1137-y
        • Young A.J.
        • Sawka M.N.
        • Epstein Y.
        • et al.
        Cooling different body surfaces during upper and lower body exercise.
        J Appl Physiol. 1987; 63: 1218-1223https://doi.org/10.1152/jappl.1987.63.3.1218
        • Higgins J.P.
        • Altman D.
        Heterogeneity.
        in: Higgins J.P. Green S. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series. Wiley, Chichester2008
        • Cohen J.
        Statistical Power Analysis for the Behavioral Sciences.
        2nd ed. Erlbaum, Hillsdale, New York1988
        • Kounalakis S.N.
        • Botonis P.G.
        • Koskolou M.D.
        • et al.
        The effect of menthol application to the skin on sweating rate response during exercise in swimmers and controls.
        Eur J Appl Physiol. 2010; 109: 183-189https://doi.org/10.1007/s00421-009-1345-6
        • Jeffries O.
        • Goldsmith M.
        • Waldron M.
        L-Menthol mouth rinse or ice slurry ingestion during the latter stages of exercise in the heat provide a novel stimulus to enhance performance despite elevation in mean body temperature.
        Eur J Appl Physiol. 2018; 118: 2435-2442https://doi.org/10.1007/s00421-018-3970-4
        • Flood T.R.
        • Waldron M.
        • Jeffries O.
        Oral L-menthol reduces thermal sensation, increases work-rate and extends time to exhaustion, in the heat at a fixed rating of perceived exertion.
        Eur J Appl Physiol. 2017; 117: 1501-1512https://doi.org/10.1007/s00421-017-3645-6
        • Barwood M.J.
        • Corbett J.
        • White D.
        • et al.
        Early change in thermal perception is not a driver of anticipatory exercise pacing in the heat.
        Br J Sports Med. 2012; 46: 936-942https://doi.org/10.1136/bjsports-2011-090536
        • Stevens C.J.
        • Bennett K.J.M.
        • Sculley D.V.
        • et al.
        A comparison of mixed-method cooling interventions on preloaded running performance in the heat.
        J Strength Cond Res. 2017; 31: 620-629https://doi.org/10.1519/JSC.0000000000001532
        • Barwood M.J.
        • Corbett J.
        • Thomas K.
        • et al.
        Relieving thermal discomfort: effects of sprayed L-menthol on perception, performance, and time trial cycling in the heat.
        Scand J Med Sci Sports. 2015; 25: 211-218https://doi.org/10.1111/sms.12395
        • Siegel R.
        • Laursen P.B.
        Keeping your cool: possible mechanisms for enhanced exercise performance in the heat with internal cooling methods.
        Sports Med. 2012; 42: 89-98https://doi.org/10.2165/11596870-000000000-00000
        • Wegmann M.
        • Faude O.
        • Poppendieck W.
        • et al.
        Pre-cooling and sports performance: a meta-analytical review.
        Sports Med. 2012; 42: 545-564https://doi.org/10.2165/11630550-000000000-00000
        • Tyler C.J.
        • Sunderland C.
        • Cheung S.S.
        The effect of cooling prior to and during exercise on exercise performance and capacity in the heat: a meta-analysis.
        Br J Sports Med. 2015; 49: 7-13https://doi.org/10.1136/bjsports-2012-091739
        • Hohenauer E.
        • Stoop R.
        • Clarys P.
        • et al.
        The effect of pre-exercise cooling on performance characteristics: a systematic review and meta-analysis.
        Int J Clin Med. 2018; 09: 117-141https://doi.org/10.4236/ijcm.2018.93012
        • Choo H.C.
        • Nosaka K.
        • Peiffer J.J.
        • et al.
        Ergogenic effects of precooling with cold water immersion and ice ingestion: a meta-analysis.
        Eur J Sport Sci. 2018; 18: 170-181https://doi.org/10.1080/17461391.2017.1405077
        • Bongers C.C.
        • Thijssen D.H.
        • Veltmeijer M.T.
        • et al.
        Precooling and percooling (cooling during exercise) both improve performance in the heat: a meta-analytical review.
        Br J Sports Med. 2015; 49: 377-384https://doi.org/10.1136/bjsports-2013-092928
        • Stevens C.J.
        • Thoseby B.
        • Sculley D.V.
        • et al.
        Running performance and thermal sensation in the heat are improved with menthol mouth rinse but not ice slurry ingestion.
        Scand J Med Sci Sports. 2016; 26: 1209-1216https://doi.org/10.1111/sms.12555
        • Mundel T.
        • Jones D.A.
        The effects of swilling an L(-)-menthol solution during exercise in the heat.
        Eur J Appl Physiol. 2010; 109: 59-65https://doi.org/10.1007/s00421-009-1180-9
        • Riera F.
        • Trong T.T.
        • Sinnapah S.
        • et al.
        Physical and perceptual cooling with beverages to increase cycle performance in a tropical climate.
        PLoS One. 2014; 9https://doi.org/10.1371/journal.pone.0103718
        • Haggard P.
        • de Boer L.
        Oral somatosensory awareness.
        Neurosci Biobehav Rev. 2014; 47: 469-484https://doi.org/10.1016/j.neubiorev.2014.09.015
        • Best R.
        • Spears I.R.
        • Hurst P.
        • et al.
        The development of a menthol solution for use during sport and exercise.
        Beverages. 2018; 4: 1-10https://doi.org/10.3390/beverages4020044
        • Craighead D.H.
        • Alexander L.M.
        Topical menthol increases cutaneous blood flow.
        Microvasc Res. 2016; 107: 39-45https://doi.org/10.1016/j.mvr.2016.04.010
        • Hunter A.M.
        • Grigson C.
        • Wade A.
        Influence of topicaly applied menthol cooling gel on soft tissue thermodynamics and arterial and cutaneous blood flow at rest.
        Int J Sports Phys Ther. 2018; 13: 483-492
        • Tajino K.
        • Hosokawa H.
        • Maegawa S.
        • et al.
        Cooling-sensitive TRPM8 is thermostat of skin temperature against cooling.
        PLoS One. 2011; 6https://doi.org/10.1371/journal.pone.0017504
        • Nakamura M.
        • Yoda T.
        • Crawshaw L.I.
        • et al.
        Regional differences in temperature sensation and thermal comfort in humans.
        J Appl Physiol. 2008; 105: 1897-1906https://doi.org/10.1152/japplphysiol.90466.2008
        • Cotter J.D.
        • Taylor N.A.
        The distribution of cutaneous sudomotor and alliesthesial thermosensitivity in mildly heat-stressed humans: an open-loop approach.
        J Physiol. 2005; 565: 335-345https://doi.org/10.1113/jphysiol.2004.081562
        • Cliff M.A.
        • Green B.G.
        Sensory irritation and coolness produced by menthol: evidence for selective desensitization of irritation.
        Physiol Behav. 1994; 56: 1021-1029
        • Yosipovitch G.
        • Szolar C.
        • Hui X.Y.
        • et al.
        Effect of topically applied menthol on thermal, pain and itch sensations and biophysical properties of the skin.
        Arch Dermatol Res. 1996; 288: 245-248
        • Barwood M.J.
        • Corbett J.
        • White D.K.
        Spraying with 0.20% L-menthol does not enhance 5 km running performance in the heat in untrained runners.
        J Sports Med Phys Fitness. 2014; 54: 595-604
        • Galpin A.J.
        • Bagley J.R.
        • Whitcomb B.
        • et al.
        Effects of Intermittent neck cooling during repeated bouts of high-intensity exercise.
        Sport (Basel, Switzerland). 2016; 4https://doi.org/10.3390/sports4030038
        • Gillis D.J.
        • House J.R.
        • Tipton M.J.
        The influence of menthol on thermoregulation and perception during exercise in warm, humid conditions.
        Eur J Appl Physiol. 2010; 110: 609-618https://doi.org/10.1007/s00421-010-1533-4
        • Gillis D.J.
        • Weston N.
        • House J.R.
        • et al.
        Influence of repeated daily menthol exposure on human temperature regulation and perception.
        Physiol Behav. 2015; 139: 511-518https://doi.org/10.1016/j.physbeh.2014.12.009
        • Gillis D.J.
        • Barwood M.J.
        • Newton P.S.
        • et al.
        The influence of a menthol and ethanol soaked garment on human temperature regulation and perception during exercise and rest in warm, humid conditions.
        J Therm Biol. 2016; 58: 99-105https://doi.org/10.1016/j.jtherbio.2016.04.009
        • Eccles R.
        Role of cold receptors and menthol in thirst, the drive to breathe and arousal.
        Appetite. 2000; 34: 29-35https://doi.org/10.1006/appe.1999.0291
        • Trong T.T.
        • Riera F.
        • Rinaldi K.
        • et al.
        Ingestion of a cold temperature/menthol beverage increases outdoor exercise performance in a hot, humid environment.
        PLoS One. 2015; 10: 1-11https://doi.org/10.1371/journal.pone.0123815
        • Kraemer W.J.
        • Ratamess N.A.
        • Maresh C.M.
        • et al.
        A cetylated fatty acid topical cream with menthol reduces pain and improves functional performance in individuals with arthritis.
        J Strength Cond Res. 2005; 19: 475-480https://doi.org/10.1519/R-505059.1