Skip to main content
Evidence-Based Supplement Research
Evidence-Based Supplement Research
Pillser
Search
Sign UpLog In

Effects of different menthol administration routes on endurance performance and physiological responses in the heat: a network meta-analysis.

  • 2026-05-18
  • Frontiers in nutrition 13
    • Yongliang Zhu
    • Junyu Zhao
    • Jiayi Yao
    • Haozhe Wang
    • Xiaotong Yuan

Study Design

Type
Systematic Review
Methods
systematically evaluate and compare the relative efficacy of three menthol administration routes-ingestion (ING), mouth rinsing (MR), and topical application (Top)-on exercise performance and physiological responses in the heat; network meta-analysis of 15 randomized controlled trials

Objective

This study employed a network meta-analysis (NMA) to systematically evaluate and compare the relative efficacy of three menthol administration routes-ingestion (ING), mouth rinsing (MR), and topical application (Top)-on exercise performance and physiological responses in the heat, aiming to explore potential task-oriented personalized supplementation strategies.

Methods

Databases including PubMed, Embase, Web of Science, and CNKI were searched for randomized controlled trials (RCTs) investigating menthol interventions on exercise performance in hot environments (T≥25 °C), with a search deadline of March 2, 2026. Two reviewers independently performed literature screening, data extraction, and risk of bias assessment using the Cochrane RoB 2.0 tool. Network meta-analysis was conducted using Stata 18.0 software.

Results

The network meta-analysis of the 15 included randomized controlled trials revealed outcome-specific trends in exercise performance, although most pairwise comparisons did not reach statistical significance. Surface under the cumulative ranking curve (SUCRA) analysis indicated that ingestion (ING) demonstrated a potential trend for improving endurance performance (SUCRA = 76.1%), while mouth rinsing (MR) showed a tendency for enhancing mean power output (SUCRA = 66.9%). Regarding physiological responses, the impact of all administration routes on core temperature (Tc) and heart rate (HR) was modest and lacked statistically significant differences compared to control conditions. Specifically, ING ranked relatively higher in maintaining core temperature (SUCRA = 67.0%), whereas topical application (Top) exhibited the weakest potential for thermoregulation (SUCRA = 6.2%) and might even lead to a slight upward trend in temperature due to the physical obstruction of heat dissipation.

Conclusion

The interventional efficacy of menthol in the heat appears to be co-regulated by the administration route and the specific exercise task. While the current evidence does not establish definitive superiority among the administration routes due to the lack of statistical significance, ingestion may serve as an exploratory option for long-duration endurance events, whereas mouth rinsing could be considered for tasks focusing on instantaneous power output. Given that menthol may mask actual subjective thermal perception without alleviating objective physiological heat strain, its application must be combined with objective physiological monitoring in practice to ensure exercise safety.

Systematic review registration

www.crd.york.ac.uk/prospero, identifier: CRD420261340546.

Research Insights

  • Peppermint→Improved Endurance

    Surface under the cumulative ranking curve (SUCRA) analysis indicated that ingestion (ING) demonstrated a potential trend for improving endurance performance (SUCRA = 76.1%)

    Effect
    Neutral
    Effect size
    Small
  • Peppermint→Improved Mean Power Output

    mouth rinsing (MR) showed a tendency for enhancing mean power output (SUCRA = 66.9%)

    Effect
    Neutral
    Effect size
    Small
  • Peppermint→Reduced Core Temperature

    the impact of all administration routes on core temperature (Tc) and heart rate (HR) was modest and lacked statistically significant differences compared to control conditions

    Effect
    Neutral
    Effect size
    Small
  • Peppermint→Reduced Heart Rate

    the impact of all administration routes on core temperature (Tc) and heart rate (HR) was modest and lacked statistically significant differences compared to control conditions

    Effect
    Neutral
    Effect size
    Small

Adverse Events Reported

  • Peppermint→Overall tolerability

    Given that menthol may mask actual subjective thermal perception without alleviating objective physiological heat strain, its application must be combined with objective physiological monitoring in practice to ensure exercise safety.

    Finding
    Reported
Back to top