Carbohydrate hastens hypervolemia achieved through ingestion of aqueous sodium solution in resting euhydrated humans

Effects of ingesting beverages containing glycerol and sodium with isomaltulose or sucrose on fluid retention in young adults: a single-blind, randomized crossover trial

We evaluated changes in hyperhydration and beverage hydration index (BHI, a composite measure of fluid balance after consuming a test beverage relative to water) during resting, induced by the consumption of beverages containing glycerol and sodium supplemented with fast-absorbing sucrose or slow-absorbing isomaltulose. In a randomized crossover, single-blinded protocol (clinical trials registry: UMIN000042644), 14 young physically active adults (three women) consumed 1 L of beverage containing either 7% glycerol + 0.5% sodium (Gly + Na), Gly + Na plus 7% sucrose (Gly + Na + Suc), Gly + Na plus 7% isomaltulose (Gly + Na + Iso), or water (CON) over a 40 min period. We assessed the change in plasma volume (ΔPV), BHI (calculated from cumulative urine output following consumption of water relative to that of the beverage), and blood glucose and sodium for 180 min after initiating ingestion. Total urine volume was reduced in all beverages containing glycerol and sodium compared to CON (all P ≤ 0.002). The addition of isomaltulose increased BHI by ∼45% (3.43 ± 1.0 vs. 2.50 ± 0.7 for Gly + Na, P = 0.011) whereas sucrose did not (2.6 ± 0.6, P = 0.826). The PV expansion was earliest for Gly + Na (30 min), slower for Gly + Na + Suc (90 min), and slowest for Gly + Na + Iso (120 min) with a concomitant lag in the increase of blood glucose and sodium concentrations. Supplementation of beverages containing glycerol and sodium with isomaltulose but not sucrose enhances BHI from those of glycerol and sodium only under a resting state, likely due to the slow absorption of isomaltulose-derived monosaccharides (i.e., glucose and fructose).

Compositional Aspects of Beverages Designed to Promote Hydration Before, During, and After Exercise: Concepts Revisited

Hypohydration can impair aerobic performance and deteriorate cognitive function during exercise. To minimize hypohydration, athletes are recommended to commence exercise at least euhydrated, ingest fluids containing sodium during long-duration and/or high-intensity exercise to prevent body mass loss over 2% and maintain elevated plasma osmolality, and rapidly restore and retain fluid and electrolyte homeostasis before a second exercise session. To achieve these goals, the compositions of the fluids consumed are key; however, it remains unclear what can be considered an optimal formulation for a hydration beverage in different settings. While carbohydrate-electrolyte solutions such as sports drinks have been extensively explored as a source of carbohydrates to meet fuel demands during intense and long-duration exercise, these formulas might not be ideal in situations where fluid and electrolyte balance is impaired, such as practicing exercise in the heat. Alternately, hypotonic compositions consisting of moderate to high levels of electrolytes (i.e., ≥45 mmol/L), mainly sodium, combined with low amounts of carbohydrates (i.e., <6%) might be useful to accelerate intestinal water absorption, maintain plasma volume and osmolality during exercise, and improve fluid retention during recovery. Future studies should compare hypotonic formulas and sports drinks in different exercise settings, evaluating different levels of sodium and/or other electrolytes, blends of carbohydrates, and novel ingredients for addressing hydration and rehydration before, during, and after exercise.

The Effect of Pre-Exercise Hyperhydration on Exercise Performance, Physiological Outcomes and Gastrointestinal Symptoms: A Systematic Review

BACKGROUND

Fluid loss during prolonged exercise in hot conditions poses thermoregulatory and cardiovascular challenges for athletes that can lead to impaired performance. Pre-exercise hyperhydration using nutritional aids is a strategy that may prevent or delay the adverse effects of dehydration and attenuate the impact of heat stress on exercise performance.

OBJECTIVES

The aim of this systematic review was to examine the current literature to determine the effect of pre-exercise hyperhydration on performance, key physiological responses and gastrointestinal symptoms.

METHODS

English language, full-text articles that compared the intervention with a baseline or placebo condition were included. An electronic search of Medline Complete, SPORTDiscus and Embase were used to identify articles with the final search conducted on 11 October 2022. Studies were assessed using the American Dietetic Association Quality Criteria Checklist.

RESULTS

Thirty-eight studies involving 403 participants (n = 361 males) were included in this review (n = 22 assessed exercise performance or capacity). Two studies reported an improvement in time-trial performance (range 5.7-11.4%), three studies reported an improvement in total work completed (kJ) (range 4-5%) and five studies reported an increase in exercise capacity (range 14.3-26.2%). During constant work rate exercise, nine studies observed a reduced mean heart rate (range 3-11 beats min-1), and eight studies reported a reduced mean core temperature (range 0.1-0.8 °C). Ten studies reported an increase in plasma volume (range 3.5-12.6%) compared with a control. Gastrointestinal symptoms were reported in 26 studies, with differences in severity potentially associated with factors within the ingestion protocol of each study (e.g. treatment, dose, ingestion rate).

CONCLUSIONS

Pre-exercise hyperhydration may improve exercise capacity during constant work rate exercise due to a reduced heart rate and core temperature, stemming from an acute increase in plasma volume. The combination of different osmotic aids (e.g. glycerol and sodium) may enhance fluid retention and this area should continue to be explored. Future research should utilise valid and reliable methods of assessing gastrointestinal symptoms. Furthermore, studies should investigate the effect of hyperhydration on different exercise modalities whilst implementing a strong level of blinding. Finally, females are vastly underrepresented, and this remains a key area of interest in this area.