Supporting physiological resilience to climate change through anthropology, environmental exercise physiology and sport science: are we doing enough?

Climate change poses escalating threats to human physiological function and health. Rising temperatures and increasing climate volatility place growing demands on thermoregulatory, cardiovascular and musculoskeletal systems, yet mitigation cannot prevent near-term impacts of acute climatic events. Complementary strategies to enhance physiological resilience-the capacity to sustain, absorb and recover from physiological stressors to maintain homeostasis-are therefore urgently needed. We argue that insights from anthropology, environmental exercise physiology and sport science offer an integrated framework for understanding and strengthening physiological resilience. Physical inactivity, affecting one-third of adults globally, compounds climate-related vulnerability by eroding the thermoregulatory, cardiovascular and musculoskeletal systems most critical for tolerating environmental stress. An anthropological perspective explains why: throughout human evolution, regular physical activity (PA) was a prerequisite for survival, shaping the biological systems that these disciplines now seek to optimise. Evidence-based strategies to strengthen physiological resilience are reviewed, including endurance and resistance training (which enhance thermoregulatory capacity, cardiovascular function and muscular resilience) and heat acclimation and acclimatisation, which improve thermal tolerance through sudomotor, cardiovascular, fluid regulatory and metabolic adaptations. Cooling strategies, cold habituation and cross-acclimation/acclimatisation offer further means of building resilience. We identify two broad at-risk groups, with particular attention to vulnerability related to ageing and other factors: those who are physically inactive and lack the resilience to sustain, absorb and recover from stressors under climatic extremes, and those who are regularly active but directly exposed to environmental volatility through occupational exposure. We advocate prioritising equitable, community-level implementation to ensure that these benefits are accessible to all.