What Do Athletes Drink During Competitive Sporting Activities?

The effect of pre-exercise oral hyperhydration on endurance exercise performance, heart rate, and thermoregulation: a meta-analytical review

This study aimed to determine the effect of pre-exercise hyperhydration on endurance performance (primary outcome), heart rate, thermoregulation, and perceptual responses (secondary outcomes). Six academic databases were searched to February 2023. Only studies reporting differences in hydration between intervention and placebo/control were included. Meta-analysis determined overall effect size (Hedges' g), and meta-regression the influence of independent moderators (ambient temperature, hyperhydration agent, exercise mode, extent of hyperhydration). Overall, 10 publications generating 19 effect estimates for primary outcomes, and 11 publications reporting 48 effect estimates for secondary outcomes, were included. A small-to-moderate improvement in time-to-exhaustion (TTE) (Hedges' g = 0.31, 95% CI: 0.13-0.50, p = 0.001) and time trial (TT) (g = 0.25, 95% CI: 0.002-0.51, p = 0.049) but not total work (TW) tasks (p = 0.120) was found following hyperhydration. No moderating effects were observed. No effect of hyperhydration was found for heart rate following steady state (SS) exercise (p = 0.069) or the performance task (p = 0.072), nor for body temperature post-SS (p = 0.132) or post-performance task (p = 0.349), but meta-regression of sodium versus glycerol showed lower body temperature post-performance task with sodium (g = 0.80, t (5) = 2.65, p = 0.046). No effects were found for perceived exertion or thermal comfort. Study heterogeneity was low, lacking representation of elite and female athletes, and weight-bearing (i.e., running) exercise modalities. These results suggest pre-exercise hyperhydration provides a small-to-moderate benefit to endurance performance in TTE and TT, but not TW performance tasks. While no moderating effects were observed, lack of heterogeneity makes it difficult to generalise these findings.

Repeatability of Ad Libitum Water Intake during Repeated 1 h Walking/Jogging Exercise Sessions Conducted under Hot Ambient Conditions

A drinking strategy aiming to replace a given percentage of the sweat losses incurred during exercise should result in reproducible fluid intake volume and, hence, fluid balance from one exercise session to the other performed under similar scenarios. Whether this may also be the case with ad libitum drinking during exercise is unclear. We characterized the repeatability of ad libitum water intake during repeated 1 h exercise sessions and examined its effect over time on fluid balance and selected physiological functions and perceptual sensations. Twelve (3 women) healthy individuals participated in this study. At weekly intervals, they completed four 2 × 30 min walking/jogging exercise bouts (55% V˙O2max, 40 °C, 20-30% relative humidity) interspersed by a 3 min recovery period. During exercise, participants consumed water (20 °C) ad libitum. There were no significant differences among the four exercise sessions for absolute water intake volume (~1000 mL·h-1), percent body mass loss (~0.4%), sweat rate (~1300 mL·h-1) and percent of sweat loss replaced by water intake (~80%). Heart rate, rectal temperature, and perceived thirst and heat stress did not differ significantly between the first and fourth exercise sessions. Perceived exertion was significantly lower during the fourth vs. the first exercise session, but the difference was trivial (<1 arbitrary unit). In conclusion, ad libitum water intake during four successive identical 1 h walking/jogging sessions conducted in the heat will result in similar water intake volumes and perturbations in fluid balance, heart rate, rectal temperature, and perceived thirst, heat stress and exertion.

SPORTS INJURIES IN HIGH-LEVEL AEROBIC GYMNASTICS ATHLETES

ABSTRACT Introduction: With the rapid development of aerobic gymnastics worldwide, research is required to constantly increase. Objective: Analyze the main causes of sports injuries, proposing measures for prevention, treatment, and rehabilitation, as well as providing a theoretical basis for reducing the risk of sports injuries and actively seeking ways and measures to prevent and treat sports injuries in aerobic gymnastics athletes. Methods: Statistical-mathematical analysis was used, mainly including the coefficient of variation method, correlation matrix method, and factor analysis. The common variable of the trend of sports injuries was found. Results: The research shows that the scientific awareness, self-protection, and injury prevention of aerobic gymnastics training strengthen the ideological education and theoretical guidance of athletes, improve athletes' awareness of sports injuries, regulate technical specifications, strengthen fitness training and improve Chinese competitive aerobics. Conclusion: In the healthy period before injuries, we should take various measures to improve physical fitness and skills, enabling good health work in the acute period after injuries and understanding the working principle of early diagnosis and treatment to better use treatment time. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Sweating Rate and Sweat Chloride Concentration of Elite Male Basketball Players Measured With a Wearable Microfluidic Device Versus the Standard Absorbent Patch Method

The purpose of this study was to compare a wearable microfluidic device and standard absorbent patch in measuring local sweating rate (LSR) and sweat chloride concentration ([Cl-]) in elite basketball players. Participants were 53 male basketball players (25 ± 3 years, 92.2 ± 10.4 kg) in the National Basketball Association's development league. Players were tested during a moderate-intensity, coach-led practice (98 ± 30 min, 21.0 ± 1.2 °C). From the right ventral forearm, sweat was collected using an absorbent patch (3M Tegaderm™ + Pad). Subsequently, LSR and local sweat [Cl-] were determined via gravimetry and ion chromatography. From the left ventral forearm, LSR and local sweat [Cl-] were measured using a wearable microfluidic device and associated smartphone application-based algorithms. Whole-body sweating rate (WBSR) was determined from pre- to postexercise change in body mass corrected for fluid/food intake (ad libitum), urine loss, and estimated respiratory water and metabolic mass loss. The WBSR values predicted by the algorithms in the smartphone application were also recorded. There were no differences between the absorbent patch and microfluidic patch for LSR (1.25 ± 0.91 mg·cm-2·min-1 vs. 1.14 ±0.78 mg·cm-2·min-1, p = .34) or local sweat [Cl-] (30.6 ± 17.3 mmol/L vs. 29.6 ± 19.4 mmol/L, p = .55). There was no difference between measured and predicted WBSR (0.97 ± 0.41 L/hr vs. 0.89 ± 0.35 L/hr, p = .22; 95% limits of agreement = 0.61 L/hr). The wearable microfluidic device provides similar LSR, local sweat [Cl-], and WBSR results compared with standard field-based methods in elite male basketball players during moderate-intensity practices.

Personalized Hydration Requirements of Runners

This study sought to (a) estimate how the duration of running influences sweat losses and contributes to the daily fluid requirement, and (b) empirically estimate the drinking rates required to prevent significant dehydration (≥2% body weight as body water). Individual sweating data and running duration were obtained from male (n = 83) and female (n = 36) runners (n = 146 total observations) performing under highly heterogeneous conditions and over a range of exercise durations (33–280 min). Running <60 min/day increased daily fluid needs by a factor of 1.3, whereas running >60 min/day increased the daily fluid need by a factor of 1.9–2.3. Running <60 min/day generally required no fluid intake to prevent significant dehydration before run completion (31/35 runners). In contrast, running >60 min/day required more than 50% replacement of sweating rates to prevent the same (65/111 runners). Overall sweat losses ranged from ∼0.2 to ∼5.0 L/day, whereas the drinking rates required to prevent significant dehydration ranged from 0 to 1.4 L/hr. The characterization of sweat losses, sweat rate, and required drinking among runners in this study indicate wide individual variability that warrants personalized hydration practices, particularly when running is prolonged (>60 min) and performance is important. This study may serve as a useful guidepost for sports dietitians when planning and communicating fluid needs to athletes, as well as complement guidance related to both personalized programmed and thirst-driven drinking strategies.

Nutritional approaches to counter performance constraints in high-level sports competition

New Findings

What is the topic of this review?

The nutritional strategies that athletes use during competition events to optimize performance and the reasons they use them.

What advances does it highlight?

A range of nutritional strategies can be used by competitive athletes, alone or in combination, to address various event‐specific factors that constrain event performance. Evidence for such practices is constantly evolving but must be combined with understanding of the complexities of real‐life sport for optimal implementation.

Abstract

High‐performance athletes share a common goal despite the unique nature of their sport: to pace or manage their performance to achieve the highest sustainable outputs over the duration of the event. Periodic or sustained decline in the optimal performance of event tasks, involves an interplay between central and peripheral phenomena that can often be reduced or delayed in onset by nutritional strategies. Contemporary nutrition practices undertaken before, during or between events include strategies to ensure the availability of limited muscle fuel stores. This includes creatine supplementation to increase muscle phosphocreatine content and consideration of the type, amount and timing of dietary carbohydrate intake to optimize muscle and liver glycogen stores or to provide additional exogenous substrate. Although there is interest in ketogenic low‐carbohydrate high‐fat diets and exogenous ketone supplements to provide alternative fuels to spare muscle carbohydrate use, present evidence suggests a limited utility of these strategies. Mouth sensing of a range of food tastants (e.g., carbohydrate, quinine, menthol, caffeine, fluid, acetic acid) may provide a central nervous system derived boost to sports performance. Finally, despite decades of research on hypohydration and exercise capacity, there is still contention around their effect on sports performance and the best guidance around hydration for sporting events. A unifying model proposes that some scenarios require personalized fluid plans while others might be managed by an ad hoc approach (ad libitum or thirst‐driven drinking) to fluid intake.

Hypohydration produced by high-intensity intermittent running increases biomarkers of renal injury in males

Purpose

Whilst there is evidence to suggest that hypohydration caused by physical work in the heat increases renal injury, whether this is the case during exercise in temperate conditions remains unknown. This study investigated the effect of manipulating hydration status during high-intensity intermittent running on biomarkers of renal injury.

Methods

After familiarisation, 14 males (age: 33 ± 7 years; V̇O_2peak: 57.1 ± 8.6 ml/kg/min; mean ± SD) completed 2 trials in a randomised cross-over design, each involving 6, 15 min blocks of shuttle running (modified Loughborough Intermittent Shuttle Test protocol) in temperate conditions (22.3 ± 1.0 °C; 47.9 ± 12.9% relative humidity). During exercise, subjects consumed either a volume of water equal to 90% of sweat losses (EU) or 75 mL water (HYP). Body mass, blood and urine samples were taken pre-exercise (baseline/pre), 30 min post-exercise (post) and 24 h post-baseline (24 h).

Results

Post-exercise, body mass loss, serum osmolality and urine osmolality were greater in HYP than EU (P ≤ 0.024). Osmolality-corrected urinary kidney injury molecule-1 (uKIM-1) concentrations were increased post-exercise (P ≤ 0.048), with greater concentrations in HYP than EU (HYP: 2.76 [1.72–4.65] ng/mOsm; EU: 1.94 [1.1–2.54] ng/mOsm; P = 0.003; median [interquartile range]). Osmolality-corrected urinary neutrophil gelatinase-associated lipocalin (uNGAL) concentrations were increased post-exercise (P < 0.001), but there was no trial by time interaction effect (P = 0.073).

Conclusion

These results suggest that hypohydration produced by high-intensity intermittent running increases renal injury, compared to when euhydration is maintained, and that the site of this increased renal injury is at the proximal tubules.

Sex differences in the physiological responses to exercise-induced dehydration: consequences and mechanisms

Physiological strain during exercise is increased by mild dehydration (∼1%-3% body mass loss). This response may be sex-dependent, but there are no direct comparative data in this regard. This review aimed to develop a framework for future research by exploring the potential impact of sex on thermoregulatory and cardiac strain associated with exercise-induced dehydration. Sex-based comparisons were achieved by comparing trends from studies that implemented similar experimental protocols but recruited males and females separately. This revealed a higher core temperature (T_c) in response to exercise-induced dehydration in both sexes; however, it seemingly occurred at a lower percent body mass loss in females. Although less clear, similar trends existed for cardiac strain. The average female may have a lower body water volume per body mass compared with males, and therefore the same percent body mass loss between the sexes may represent a larger portion of total body water in females potentially posing a greater physiological strain. In addition, the rate at which T_c increases at exercise onset might be faster in females and induce a greater thermoregulatory challenge earlier into exercise. The T_c response at exercise onset is associated with lower sweating rates in females, which is commonly attributed to sex differences in metabolic heat production. However, a reduced sweat gland sensitivity to stimuli, lower fluid output per sweat gland, and sex hormones promoting fluid retention in females may also contribute. In conclusion, the limited evidence suggests that sex-based differences exist in thermoregulatory and cardiac strain associated with exercise-induced dehydration, and this warrants future investigations.

Flattened cola improves high-intensity interval performance in competitive cyclists

PURPOSE

Some cyclists consume flattened cola during competitive events, but limited research has investigated if cola beverages elicit ergogenic effects, particularly on high-intensity exercise performance. Whether the potentially beneficial effects of cola are due to the caffeine and/or the carbohydrate content is also unclear. This study assessed the ergogenic effects of different cola beverages on performance during a constant power bout (CPB) and subsequent high-intensity interval efforts in competitive cyclists.

METHODS

In a randomized, double-blind, cross-over design, competitive cyclists (n = 13; [Formula: see text]O_2max 65.7 ± 5.9 ml kg^-1 min^-1) completed a 45-min CPB at 69% of maximum workload (W_max), followed by four maximal 1-min high-intensity intervals (HII) against a resistance of 0.5 N kg^-1. Participants consumed 16 ml kg^-1 total (intermittantly at four time points) of flattened decaffinated diet cola (PLA), caffeinated diet cola (CAF) or cola containing caffeine and carbohydrates (CAF + CHO).

RESULTS

During the CPB, ratings of perceived exertion were lower in the CAF + CHO and CAF conditions compared to PLA (both, P < 0.04). Compared to PLA, CAF + CHO and CAF similarly increased (all, P < 0.049) mean power (CAF + CHO: 448 ± 51 W; CAF: 448 ± 50 W; PLA: 434 ± 57 W), minimum power (CAF + CHO: 353 ± 45 W; CAF: 352 ± 51 W; PLA: 324 ± 49 W) and total work (CAF + CHO: 26.9 ± 3.1 kJ; CAF: 26.9 ± 3.0 kJ; PLA: 26.0 ± 3.4 kJ), but not peak power (CAF + CHO: 692 ± 117 W; CAF: 674 ± 114 W; PLA: 670 ± 113 W; all, P > 0.57) during the HII.

CONCLUSION

Cola containing caffeine with or without carbohydrates favorably influenced perceived effort during the CPB and enhanced mean and minimum power during repeated maximal intervals. We provide evidence supporting the consumption of commercially available cola for high-intensity cycling in competitive cyclists.

Predicted sweat rates for group water planning in sport: accuracy and application

This study tested the accuracy of a novel, limited-availability web application (H₂Q™) for predicting sweat rates in a variety of sports using estimates of energy expenditure and air temperature only. The application of predictions for group water planning was investigated for soccer match play. Fourteen open literature studies were identified where group sweat rates were reported (n = 20 group means comprising 230 individual observations from 179 athletes) with fidelity. Sports represented included: walking, cycling, swimming, and soccer match play. The accuracy of H₂Q™ sweat rates was tested by comparing to measured group sweat rates using the concordance correlation coefficient (CCC) with 95% confidence interval [CI]. The relative absolute error (RAE) with 95% [CI] was also assessed, whereby the mean absolute error was expressed relative to an acceptance limit of 0.250 L/h. The CCC was 0.98 [0.95, 0.99] and the RAE was 0.449 [0.279, 0.620], indicating that the prediction error was on average 0.112 L/h. The RAE was < 1.0 for 19/20 observations (95%). Drink volumes modeled as a proxy for sweat losses during soccer match play prevented dehydration (< 1% loss of body mass). The H₂Q™ web application demonstrated high group sweat prediction accuracy for the variety of sports activities tested. Water planning for soccer match play suggests the feasibility of easily and accurately predicting sweat rates to plan group water needs and promote optimal hydration in training and/or competition.

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

There has been substantial progress in the knowledge of exercise and type 1 diabetes, with the development of guidelines for optimal glucose management. In addition, an increasing number of people living with type 1 diabetes are pushing their physical limits to compete at the highest level of sport. However, the post-exercise recovery routine, particularly with a focus on sporting performance, has received little attention within the scientific literature, with most of the focus being placed on insulin or nutritional adaptations to manage glycaemia before and during the exercise bout. The post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the rest of the day and overnight. The absence of clear guidance for the post-exercise period means that people with type 1 diabetes should either develop their own recovery strategies on the basis of individual trial and error, or adhere to guidelines that have been developed for people without diabetes. This Review provides an up-to-date consensus on post-exercise recovery and glucose management for individuals living with type 1 diabetes. We aim to: (1) outline the principles and time course of post-exercise recovery, highlighting the implications and challenges for endurance athletes living with type 1 diabetes; (2) provide an overview of potential strategies for post-exercise recovery that could be used by athletes with type 1 diabetes to optimise recovery and adaptation, alongside improved glycaemic monitoring and management; and (3) highlight the potential for technology to ease the burden of managing glycaemia in the post-exercise recovery period.

Different Waters for Different Performances: Can We Imagine Sport-Related Natural Mineral Spring Waters?

Preserving the hydration status means to balance daily fluids and salt losses with gains, where the losses depend on several physiological and environmental factors. Especially for athletes, these losses could be relevant and negatively influence the performance: therefore, their hydro-saline status must be preserved with personalized pre- and rehydration plans all along the performance period. Scientific literature in this field is mainly dedicated to artificial sport drinks. Different territories in most world areas are rich in drinking natural mineral spring waters with saline compositions that reflect their geological origin and that are used for human health (often under medical prescription). However, scarce scientific attention has been dedicated to the use of these waters for athletes. We therefore reviewed the existing literature from the innovative viewpoint of matching spring water mineral compositions with different athletic performances and their hydro-saline requirements.

Nutritional Concerns for the Artistic Athlete

Performing artists are similar to sports athletes, with repeated patterns of training and performing. This requires that artistic athletes manage the dynamic interaction between energy/nutrient/fluid utilization and provision to assure long, healthful, and successful careers. Although sports athletes have an abundance of science-based nutritional guidance available, there are few nutrition-focused resources available to artistic athletes, which can result in failure to optimally satisfy the artistic athlete's individual nutritional needs. The purpose of this article is to review common nutritional issues faced by artistic athletes and to present science-based nutrition strategies that can aid in lowering nutrition-associated health and performance risks.

Betaine Supplementation May Improve Heat Tolerance: Potential Mechanisms in Humans

Betaine has been demonstrated to increase tolerance to hypertonic and thermal stressors. At the cellular level, intracellular betaine functions similar to molecular chaperones, thereby reducing the need for inducible heat shock protein expression. In addition to stabilizing protein conformations, betaine has been demonstrated to reduce oxidative damage. For the enterocyte, during periods of reduced perfusion as well as greater oxidative, thermal, and hypertonic stress (i.e., prolonged exercise in hot-humid conditions), betaine results in greater villi length and evidence for greater membrane integrity. Collectively, this reduces exercise-induced gut permeability, protecting against bacterial translocation and endotoxemia. At the systemic level, chronic betaine intake has been shown to reduce core temperature, all-cause mortality, markers of inflammation, and change blood chemistry in several animal models when exposed to heat stress. Despite convincing research in cell culture and animal models, only one published study exists exploring betaine's thermoregulatory function in humans. If the same premise holds true for humans, chronic betaine consumption may increase heat tolerance and provide another avenue of supplementation for those who find that heat stress is a major factor in their work, or training for exercise and sport. Yet, this remains speculative until data demonstrate such effects in humans.

Effect of Drinking Rate on the Retention of Water or Milk Following Exercise-Induced Dehydration

This study investigated the effect of drinking rate on fluid retention of milk and water following exercise-induced dehydration. In Part A, 12 male participants lost 1.9% ± 0.3% body mass through cycle exercise on four occasions. Following exercise, plain water or low-fat milk equal to the volume of sweat lost during exercise was provided. Beverages were ingested over 30 or 90 min, resulting in four beverage treatments: water 30 min, water 90 min, milk 30 min, and milk 90 min. In Part B, 12 participants (nine males and three females) lost 2.0% ± 0.3% body mass through cycle exercise on four occasions. Following exercise, plain water equal to the volume of sweat lost during exercise was provided. Water was ingested over 15 min (DR15), 45 min (DR45), or 90 min (DR90), with either DR15 or DR45 repeated. In both trials, nude body mass, urine volume, urine specific gravity and osmolality, plasma osmolality, and subjective ratings of gastrointestinal symptoms were obtained preexercise and every hour for 3 hr after the onset of drinking. In Part A, no effect of drinking rate was observed on the proportion of fluid retained, but milk retention was greater (p < .01) than water (water 30 min: 57% ± 16%, water 90 min: 60% ± 20%, milk 30 min: 83% ± 6%, and milk 90 min: 85% ± 7%). In Part B, fluid retention was greater in DR90 (57% ± 13%) than DR15 (50% ± 11%, p < .05), but this was within test-retest variation determined from the repeated trials (coefficient of variation: 17%). Within the range of drinking rates investigated the nutrient composition of a beverage has a more pronounced impact on fluid retention than the ingestion rate.

Practical Hydration Solutions for Sports

Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many physiological, behavioral, logistical and psychological issues that determine both the athlete’s fluid needs during sport and his/her opportunity to address them; these are often specific to the environment, the event and the individual athlete. In this paper we address the major considerations for assessing hydration status in athletes and practical solutions to overcome obstacles of a given sport. Based on these solutions, practitioners can better advise athletes to develop practices that optimize hydration for their sports.

Rehydrating efficacy of maple water after exercise-induced dehydration

Dehydration impairs physiological function and physical performance, thus understanding effective rehydration strategies is paramount. Despite growing interest in natural rehydrating beverages, no study has examined maple water (MW).

PURPOSE

To investigate the rehydrating efficacy of MW after exercise-induced dehydration.

METHODS

Using a single-blind, counterbalanced, crossover design, we compared the rehydrating efficacy of MW vs. maple-flavored bottled water (control) in 26 young healthy (22 ± 4 yrs., 24 ± 4 kg/m²) males (n = 13) and females (n = 13) after exercise-induced dehydration (~ 2.0%ΔBody Weight [BW]) in the heat (30 °C, 50% relative humidity [RH]). Hydration indicators (BW, salivary and urine osmolality [SOsm/UOsm], urine specific gravity [USG], urine volume [UV], urine color [UC]), thirst, fatigue, and recovery (heart rate [HR)], and HR variability [HRV]) were taken at baseline, post-exercise, 0.5, 1, and 2 h post-consumption of 1 L of MW or control.

RESULTS

Following similar dehydration (~ 2%ΔBW), MW had no differential (p > 0.05) impact on any measure of rehydration. Likely due to greater beverage osmolality (81 ± 1.4 vs. 11 ± 0.7 mOsmol/kg), thirst sensation remained 12% higher with MW (p <  0.05). When sex was considered, females had lower UV, elevated UOsm (p < 0.05), trends for higher ΔBW, USG, but similar SOsm. Analysis of beverages and urine for antioxidant potential (AP) revealed a four-fold greater AP in MW, which increased peak urine AP (9.4 ± 0.7 vs. 7.6 ± 1.0 mmol, MW vs. control, p <  0.05).

CONCLUSION

Electrolyte-containing MW, was similar in effectiveness to water, but has antioxidant properties. Furthermore, trends for sex differences were discovered in urinary, but not salivary, hydration markers, with discrepancies in kinetics between fluid compartments both warranting further study.

Intermittent sprint performance in the heat is not altered by augmenting thermal perception via L-menthol or capsaicin mouth rinses

Purpose

Cooling sensations elicited by mouth rinsing with L-menthol have been reported as ergogenic. Presently, responses to L-menthol mouth rinsing during intermittent sprint performance (ISP) in the heat are unknown and the impact of increased thermal perception on ISP via capsaicin has also not been quantified. This experiment aimed to identify whether eliciting cooling/warming sensations via L-menthol/capsaicin would alter ISP in the heat.

Method

Fourteen participants (mass = 72 ± 9 kg, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot {V}{{\text{O}}_{2{\text{peak}}}}$$\end{document}V˙O2peak = 3.30 ± 0.90 L min⁻¹), undertook four experimental trials, involving 40 min of ISP in hot conditions (40.2 ± 0.6 °C, 42 ± 2% R.H.) with mouth rinsing (25 mL, 6 s) at the protocol onset, and every 10 min thereafter. Cooling (0.01% L-menthol; MEN), warming (0.2% capsaicin; CAP), placebo (0.3 sham-CHO; PLA), and control (water; CON) mouth rinses were utilized. Performance was quantified via power (PP) and work done (WD) during sprints. Heart rate (HR), core (T_rec) and skin (T_skin) temperature, perceived exertion (RPE), thermal sensation (T_sens), and comfort (T_com) were measured at 10 min intervals. Sweat rate (whole-body sweat rate) was calculated from ∆mass.

Result

PP reduced over time (P < 0.05); however, no change was observed between trials for PP or WD (P > 0.05). T_com increased over time and was lower in MEN (2.7 ± 1.1; P < 0.05) with no difference between CAP (3.1 ± 1.2), PLA (3.2 ± 1.3) and CON (3.1 ± 1.3). RPE, T_sens HR, T_rec, and T_skin increased over time (P < 0.05) with no between trial differences (P > 0.05).

Conclusion

Despite improved thermal comfort via L-menthol, ISP did not improve. Capsaicin did not alter thermal perception or ISP. The reduction in ISP over time in hot conditions is not influenced by thermal perception.

Electronic supplementary material

The online version of this article (10.1007/s00421-018-4055-0) contains supplementary material, which is available to authorized users.

Swifter, higher, stronger: What’s on the menu?

The exploits of elite athletes delight, frustrate, and confound us as they strive to reach their physiological, psychological, and biomechanical limits. We dissect nutritional approaches to optimal performance, showcasing the contribution of modern sports science to gold medals and world titles. Despite an enduring belief in a single, superior “athletic diet,” diversity in sports nutrition practices among successful athletes arises from the specificity of the metabolic demands of different sports and the periodization of training and competition goals. Pragmatic implementation of nutrition strategies in real-world scenarios and the prioritization of important strategies when nutrition themes are in conflict add to this variation. Lastly, differences in athlete practices both promote and reflect areas of controversy and disagreement among sports nutrition experts.

Sodium bicarbonate supplementation does not improve elite women's team sport running or field hockey skill performance

Team sports, such as field hockey, incorporate high-intensity repeated sprints, interspersed with low-intensity running, which can result in acidosis. The aim of the present study was to examine the effect of acute sodium bicarbonate (SB) supplementation on team sport running and skill performance. Eight elite female field hockey players (age 23 ± 5 years, body mass 62.6 ± 8.4 kg, height 1.66 ± 0.05 m) completed three Field Hockey Skill Tests (FHST) interspersed with four sets of the Loughborough Intermittent Shuttle Test (LIST). Prior to exercise, participants were supplemented with capsules equivalent to 0.2 g·kg-1 body mass (BM) of a placebo (maltodextrin) or 0.3 g·kg-1 BM SB. Field hockey skill performance incorporated overall performance time (PFT), movement time (MT), decision-making time (DMT), and penalty time (PT). Sprint time (ST), rating of perceived exertion (RPE), blood lactate concentration, bicarbonate anion ( HCO 3 - ) concentration, pH, and base excess were measured at various time points. Data (mean ± SD) were analyzed using a two-way analysis of variance (ANOVA) with repeated measures, with Hedges g effect sizes used to interpret the magnitude of differences. Bicarbonate anion concentration (+5.4 ± 2.6 mmol·L-1 ) and pH (+0.06 ± 0.03) were greater during the bicarbonate trial compared with the placebo (P < 0.001). Bicarbonate did not alter PFT (placebo: 87.9 ± 6.9 sec; bicarbonate: 89.0 ± 7.8 sec, P = 0.544, g = 0.14), MT, DMT, PT (all P > 0.30) or ST (placebo: 2.87 ± 0.12 sec; bicarbonate: 2.86 ± 0.12 sec, P = 0.893, g = -0.08). RPE was lower during the SB condition (placebo: 13 ± 2; bicarbonate: 12 ± 2, P = 0.021, g = -0.41). Acute ingestion of bicarbonate did not improve sprint or sport-specific skill performance. Bicarbonate ingestion did result in a lower perception of effort during team-sport running, which may have performance implications in a competitive match situation.

Working Dogs Drinking a Nutrient-Enriched Water Maintain Cooler Body Temperature and Improved Pulse Rate Recovery After Exercise

Exercise-related physiological changes were evaluated in hydrated, exercise-conditioned working dogs with free access to tap water (TW) with or without a nutrient-enriched water supplement (NW). Physiological samples and measures were collected before and after work-related field tasks in a warm and moderately humid ambient environment. In a cross-over design study, 12 dogs (age range 8-23 months) were evaluated on 3 separate occasions within each period with exercise bouts up to 30 min, on days -4, 3, and 11. Dogs were offered either ad libitum TW or portion-controlled NW daily plus ad libitum TW. Prior to and serially after exercise, pulse rate (PR), core (BT_core) and ear (BT_ear) temperature were recorded. Urine was collected first thing in the morning, whereas blood samples collected and body weight (BW) recorded pre- and immediately post exercise. Ambient temperature was above 21.7°C (71°F) and relative humidity ranged from 36 to 76%. Activity parameters, AM urine measures, post-exercise percent change of BW, resting PR and resting BT_core did not differ between treatment groups on any exercise day. At the completion of exercise, mean BT_core for all dogs ranged from 104.8 to 105.6°F. Immediate post-exercise BT_ear was always lower compared to BT_core and means ranged from 103.3 to 104.0°F. The effect of time was highly significant (P < 0.001) for both BT measures with both BT_core and BT_ear recovering to resting levels by 60 min post exercise. PR and several blood values showed a significant main effect of time. Over the recovery period, dogs in the NW group had lower mean BT_ear and PR by 0.6°F and 3.4 bpm, respectively. Daily ingestion of a NW in combination with free access to TW can reduce the post-exercise-related BT_core and BT_ear hyperthermia, and improve pulse rate recovery following exercise in this population of working dogs undergoing 30 min bout of exercise.

Fluid, energy, and nutrient recovery via ad libitum intake of different commercial beverages and food in female athletes

This study investigated the effect of consuming different commercial beverages with food ad libitum after exercise on fluid, energy, and nutrient recovery in trained females. On 4 separate occasions, 8 females (body mass (BM): 61.8 ± 10.7 kg; maximal oxygen uptake: 46.3 ± 7.5 mL·kg^-1·min^-1) lost 2.0% ± 0.3% BM cycling at ∼75% maximal oxygen uptake before completing a 4-h recovery period with ad libitum access to 1 of 4 beverages: Water, Powerade (Sports Drink), Up & Go Reduced Sugar (Lower Sugar (LS)-MILK) or Up & Go Energize (Higher Protein (HP)-MILK). Participants also had two 15-min opportunities to access food within the first 2 h of the recovery period. Beverage intake, total water/nutrient intake, and indicators of fluid recovery (BM, urine output, plasma osmolality), gastrointestinal tolerance and palatability were assessed periodically. While total water intake (from food and beverage) (Water: 1918 ± 580 g; Sports Drink: 1809 ± 338 g; LS-MILK: 1458 ± 431 g; HP-MILK: 1523 ± 472 g; p = 0.010) and total urine output (Water: 566 ± 314 g; Sports Drink: 459 ± 290 g; LS-MILK: 220 ± 53 g; HP-MILK: 230 ± 117 g; p = 0.009) differed significantly by beverage, the quantity of ingested water retained was similar across treatments (Water: 1352 ± 462 g; Sports Drink: 1349 ± 407 g; LS-MILK: 1238 ± 400 g; HP-MILK: 1293 ± 453 g; p = 0.691). Total energy intake (from food and beverage) increased in proportion to the energy density of the beverage (Water: 4129 ± 1080 kJ; Sports Drink: 5167 ± 643 kJ; LS-MILK: 6019 ± 1925 kJ; HP-MILK: 7096 ± 2058 kJ; p = 0.014). When consumed voluntarily and with food, different beverages promote similar levels of fluid recovery, but alter energy/nutrient intakes. Providing access to food and understanding the longer-term dietary goals of female athletes are important considerations when recommending a recovery beverage.

Fluid Intake Habits in Type 1 Diabetes Individuals during Typical Training Bouts

BACKGROUND/AIMS

Hyperglycemia may influence the hydration status in diabetic individuals. During exercise, type 1 diabetes mellitus (T1DM) individuals may be challenged by a higher risk of dehydration due to a combination of fluid losses from sweat and increased urine output via glycosuria. So far, no study has characterised spontaneous fluid intake in T1DM individuals during active trainings.

METHODS

A validated questionnaire was used to assess T1DM participants' diabetes therapy, sports characteristics and fluid intake during training; results were then compared to an age- and sport-matched sample of non-diabetic individuals.

RESULTS

Ninety individuals completed the survey (n = 45 T1DM individuals, n = 45 matched controls). A proportion of T1DM -individuals reported blood glucose levels greater than 10.0 mmol at both the start (28.9%) and end (24.4%) of the exercise. The mean self-reported fluid intake was greater in T1DM (0.60 ± 0.47 L·h-1) compared to that of the control (0.37 ± 0.28 L·h-1, p < 0.05). In spite of drinking fluid volumes in line with international guidelines, 84.4% of those with T1DM reported that they were still feeling thirsty at the end of their training session.

CONCLUSIONS

T1DM individuals self-report spontaneously consuming fluid adequate volumes suggested by sport nutrition guidelines for non-diabetic athletes. Discrepancies in the T1DM subjectively reported feelings of thirst suggest that more education on hydration during exercise is needed for this population to adequately compensate for elevated blood glucose levels. It remains to be established whether fluid volumes suggested for healthy athletes are adequate for maintaining euhydration in T1DM patients due to their altered diuresis.

Body mass changes during training in elite rugby union: Is a single test of hydration indices reliable?

There is limited research studying fluid and electrolyte balance in rugby union players, and a paucity of information regarding the test-retest reliability. This study describes the fluid balance of elite rugby union players across multiple squads and the reliability of fluid balance measures between two equivalent training sessions. Sixty-one elite rugby players completed a single fluid balance testing session during a game simulation training session. A subsample of 21 players completed a second fluid balance testing session during an equivalent training session. Players were weighed in minimal clothing before and after each training session. Each player was provided with their own drinks which were weighed before and after each training session. More players gained body weight (9 (14.8%)) during training than lost greater than 2% of their initial body mass (1 (1.6%)). Pre-training body mass and rate of fluid loss were significantly associated (r = 0.318, p = .013). There was a significant correlation between rate of fluid loss in sessions 1 (1.74 ± 0.32 L h^-1) and 2 (1.10 ± 0.31 L. h^-1), (r = 0.470, p = .032). This could be useful for nutritionists working with rugby squads to identify players with high sweat losses.

Measured and perceived indices of fluid balance in professional athletes. The use and impact of hydration assessment strategies

BACKGROUND

To determine athletes perceived and measured indices of fluid balance during training and the influence of hydration strategy use on these parameters.

METHODS

Thirty-three professional rugby union players completed a 120 minute training session in hot conditions (35°C, 40% relative humidity). Pre-training hydration status, sweat loss, fluid intake and changes in body mass (BM) were obtained. The use of hydration assessment techniques and players perceptions of fluid intake and sweat loss were obtained via a questionnaire.

RESULTS

The majority of players (78%) used urine colour to determine pre-training hydration status but the use of hydration assessment techniques did not influence pre-training hydration status (1.025 ± 0.005 vs. 1.023 ± 0.013 g^.ml^-1, P = .811). Players underestimated sweat loss (73 ± 17%) to a greater extent than fluid intake (37 ± 28%) which resulted in players perceiving they were in positive fluid balance (0.5 ± 0.8% BM) rather than the measured negative fluid balance (-1.0 ± 0.7% BM). Forty-eight percent of players used hydration monitoring strategies during exercise but no player used changes in BM to help guide fluid replacement.

CONCLUSION

Players have difficulty perceiving fluid intake and sweat loss during training. However, the use of hydration monitoring techniques did not affect fluid balance before or during training.

Nutritional needs in the professional practice of swimming: a review

[Purpose]

Swimming requires developing a high aerobic and anaerobic capacity for strength and technical efficiency. The purpose of this study was to establish the nutritional requirements and dietary strategies that can optimize swimming performance.

[Methods]

Several related studies retrieved from the databases, Dialnet, Elsevier, Medline, Pubmed, and Web of Science, through keyword search strategies were reviewed.

[Results]

The recommended carbohydrate intake ranges between 6-10-12 g/kg/d, protein 2 g/kg/d, and fat should surpass 20-25% of the daily intake.

[Conclusion]

Performance can be optimized with a hydration plan, as well as adequate periodization of supplements, such as caffeine, creatine, sodium bicarbonate, B-alanine, beetroot juice, Vitamin D, bovine colostrum, and HMB.

Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance

Sweat losses in team sports can be significant due to repeated bursts of high-intensity activity, as well as the large body size of athletes, equipment and uniform requirements, and environmental heat stress often present during training and competition. In this paper we aimed to: (1) describe sweat losses and fluid balance changes reported in team sport athletes, (2) review the literature assessing the impact of hypohydration on cognitive, technical, and physical performance in sports-specific studies, (3) briefly review the potential mechanisms by which hypohydration may impact team sport performance, and (4) discuss considerations for future directions. Significant hypohydration (mean body mass loss (BML) >2%) has been reported most consistently in soccer. Although American Football, rugby, basketball, tennis, and ice hockey have reported high sweating rates, fluid balance disturbances have generally been mild (mean BML <2%), suggesting that drinking opportunities were sufficient for most athletes to offset significant fluid losses. The effect of hydration status on team sport performance has been studied mostly in soccer, basketball, cricket, and baseball, with mixed results. Hypohydration typically impaired performance at higher levels of BML (3-4%) and when the method of dehydration involved heat stress. Increased subjective ratings of fatigue and perceived exertion consistently accompanied hypohydration and could explain, in part, the performance impairments reported in some studies. More research is needed to develop valid, reliable, and sensitive sport-specific protocols and should be used in future studies to determine the effects of hypohydration and modifying factors (e.g., age, sex, athlete caliber) on team sport performance.

Reported Hydration Beliefs and Behaviors without Effect on Plasma Sodium in Endurance Athletes

Purpose: Little information is available on the association of hydration beliefs and behaviors in endurance athletes and exercise-associated hyponatremia (EAH). The aim of the present study was to determine hydration beliefs and behaviors in endurance athletes.

Method: A 100 and 38 recreational athletes [107 mountain bikers (MTBers) and 31 runners] competing in seven different endurance and ultra-endurance races completed pre- and post-race questionnaires, and a subgroup of 113 (82%) participants (82 MTBers and 31 runners) also provided their blood samples.

Result: More than half of the participants had some pre-race (59%), mid-race (58%), and post-race (55%) drinking plan. However, the participants simultaneously reported that temperature (66%), thirst (52%), and plan (37%) affected their drinking behavior during the race. More experienced (years of active sport: p = 0.002; number of completed races: p < 0.026) and trained (p = 0.024) athletes with better race performance (p = 0.026) showed a more profound knowledge of EAH, nevertheless, this did not influence their planned hydration, reported fluid intake, or post-race plasma sodium. Thirteen (12%) hyponatremic participants did not differ in their hydration beliefs, race behaviors, or reported fluid intake from those without post-race EAH. Compared to MTBers, runners more often reported knowledge of the volumes of drinks offered at fluid stations (p < 0.001) and information on how much to drink pre-race (p < 0.001), yet this was not associated with having a drinking plan (p > 0.05). MTBers with hydration information planned more than other MTBers (p = 0.004). In comparison with runners, more MTBers reported riding with their own fluids (p < 0.001) and planning to drink at fluid stations (p = 0.003). On the whole, hydration information was positively associated with hydration planning (n = 138) (p = 0.003); nevertheless, the actual reported fluid intake did not differ between the group with and without hydration information, or with and without a pre-race drinking plan (p > 0.05).

Conclusion: In summary, hydration beliefs and behaviors in the endurance athletes do not appear to affect the development of asymptomatic EAH.

Why do team-sport athletes drink fluid in excess when exercising in cool conditions?

This study assessed the potential physiological and perceptual drivers of fluid intake and thirst sensation during intermittent exercise. Ten male rugby players (17 ± 1 years, stature: 179.1 ± 4.2 cm, body mass (BM): 81.9 ± 8.1 kg) participated in six 6-min small-sided games, interspersed with 2 min rest, where fluid intake was ad libitum during rest periods. Pre- and postmeasurements of BM, subjective ratings (thirst, thermal comfort, thermal sensation, mouth dryness), plasma osmolality (POsm), serum sodium concentration (S[Na⁺]), haematocrit and haemoglobin (to calculate plasma volume change; PV) were taken. Fluid intake was measured during rest periods. BM change was -0.17 ± 0.59% and fluid intake was 0.88 ± 0.38 L. Pre- to post-POsm decreased (-3.1 ± 2.3 mOsm·kg^-1; p = 0.002) and S[Na⁺] remained similar (-0.3 ± 0.7 mmol·L^-1, p = 0.193). ΔPV was 5.84 ± 3.65%. Fluid intake displayed a relationship with pre-POsm (r = -0.640, p = 0.046), prethermal comfort (r = 0.651; p = -0.041), ΔS[Na⁺] (r = 0.816, p = 0.004), and ΔPV (r = 0.740; p = 0.014). ΔThirst sensation displayed a relationship with premouth dryness (r = 0.861, p = 0.006) and Δmouth dryness (r = 0.878, p = 0.004). Yet a weak positive relationship between Δthirst sensation and fluid intake was observed (r = 0.085, p = 0.841). These data observed in an ambient temperature of 13.6 ± 0.9 °C, suggest team-sport athletes drink in excess of fluid homeostasis requirements and thirst sensation in cool conditions; however, this was not influenced by thermal discomfort.

Post-Exercise Rehydration: Effect of Consumption of Beer with Varying Alcohol Content on Fluid Balance after Mild Dehydration

Purpose

The effects of moderate beer consumption after physical activity on rehydration and fluid balance are not completely clear. Therefore, in this study, we investigated the effect of beer consumption, with varying alcohol content, on fluid balance after exercise-induced dehydration.

Methods

Eleven healthy males were included in this cross over study (age 24.5 ± 4.7 years, body weight 75.4 ± 3.3 kg, VO_2max 58.3 ± 6.4 mL kg min⁻¹). Subjects exercised on a cycle ergometer for 45 min at 60% of their maximal power output (W_max) until mild dehydration (1% body mass loss). Thereafter, in random order, one of five experimental beverages was consumed, in an amount equal to 100% of their sweat loss: non-alcoholic beer (0.0%), low-alcohol beer (2.0%), full-strength beer (5.0%), an isotonic sports drink, and water. Fluid balance was assessed up till 5 h after rehydration.

Results

After 1 h, urine production was significantly higher for 5% beer compared to the isotonic sports drink (299 ± 143 vs. 105 ± 67 mL; p < 0.01). At the end of the 5-h observation period, net fluid balance (NFB) was negative for all conditions (p = 0.681), with the poorest fluid retention percentage for 5% beer (21% fluid retention) and the best percentage for the isotonic sports drink (42%). Non-alcoholic beer, low-alcoholic beer, and water resulted in fluid retention of 36, 36, and 34%, respectively (p = 0.460).

Conclusion

There was no difference in NFB between the different beverages. Only a short-lived difference between full-strength beer and the isotonic sports drink in urine output and NFB was observed after mild exercise-induced dehydration. Fluid replacement – either in the form of non-alcoholic beer, low-alcoholic beer, full-strength beer, water, or an isotonic sports drink of 100% of body mass loss was not sufficient to achieve full rehydration. The combination of a moderate amount of beer, with varying alcohol content, enough water or electrolyte- and carbohydrate beverages, and salty foods might improve rehydration, but more research is needed.

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's, and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert.

Influence of Dehydration on Intermittent Sprint Performance

This study examined the effects of dehydration on intermittent sprint performance and perceptual responses. Eight male collegiate baseball players completed intermittent sprints either dehydrated (DEHY) by 3% body mass or euhydrated (EU). Body mass was reduced through exercise in the heat with controlled fluid restriction occurring 1 day before the trial. Participants completed twenty-four 30-m sprints divided into 3 bouts of 8 sprints with 45 seconds of rest between each sprint and 3 minutes between each bout. Perceived recovery status (PRS) scale was recorded before the start of each trial. Heart rate (HR), ratings of perceived exertion (RPE) (0-10 OMNI scale), and perceived readiness (PR) scale were recorded after every sprint, and session RPE (SRPE) was recorded 20 minutes after completing the entire session. A 2 (condition) × 3 (bout of sprints) repeated-measures ANOVA revealed a significant main effect of condition on mean sprint time (p = 0.03), HR (p < 0.01), RPE (p = 0.01), and PR (p = 0.02). Post hoc tests showed significantly faster mean sprint times for EU vs. DEHY during the second (4.87 ± 0.29 vs. 5.03 ± 0.33 seconds; p = 0.01) and third bouts of sprints (4.91 ± 0.29 vs. 5.12 ± 0.44 seconds; p = 0.02). Heart rate was also significantly lower (p ≤ 0.05) for EU during the second and third bouts. Post hoc measures also showed significantly impaired (p ≤ 0.05) feelings of recovery (PRS) before exercise and increased (p ≤ 0.05) perceptual strain before each bout (PR) during the second and third bouts of repeated sprint work (i.e., RPE and PR) and after the total session (SRPE) in the DEHY condition. Dehydration impaired sprint performance, negatively altered perception of recovery status before exercise, and increased RPE and HR response.

Evidence of disturbed sleep and mood state in well-trained athletes during short-term intensified training with and without a high carbohydrate nutritional intervention

Few studies have investigated the effects of exercise training on sleep physiology in well-trained athletes. We investigated changes in sleep markers, mood state and exercise performance in well-trained cyclists undergoing short-term intensified training and carbohydrate nutritional intervention. Thirteen highly-trained male cyclists (age: 25 ± 6y, [Formula: see text]O_2max: 72 ± 5 ml/kg/min) participated in two 9-day periods of intensified training while undergoing a high (HCHO) or moderate (CON) carbohydrate nutritional intervention before, during and after training sessions. Sleep was measured each night via wristwatch actigraphy. Mood state questionnaires were completed daily. Performance was assessed with maximal oxygen uptake ([Formula: see text]. Percentage sleep time fell during intensified training (87.9 ± 1.5 to 82.5 ± 2.3%; p < 0.05) despite an increase in time in bed (456 ± 50 to 509 ± 48 min; p = 0.02). Sleep efficiency decreased during intensified training (83.1 ± 5.3 to 77.8 ± 8.6%; p < 0.05). Actual sleep time was significantly higher in CON than HCHO throughout intensified training. Mood disturbance increased during intensified training and was higher in CON than HCHO (p < 0.05). Performance in the [Formula: see text] exercise protocol fell significantly with intensified training. The main findings of this study were that 9-days of intensified training in highly-trained cyclists resulted in significant and progressive declines in sleep quality, mood state and maximal exercise performance.

Role of nutrition in performance enhancement and postexercise recovery

A number of factors contribute to success in sport, and diet is a key component. An athlete's dietary requirements depend on several aspects, including the sport, the athlete's goals, the environment, and practical issues. The importance of individualized dietary advice has been increasingly recognized, including day-to-day dietary advice and specific advice before, during, and after training and/or competition. Athletes use a range of dietary strategies to improve performance, with maximizing glycogen stores a key strategy for many. Carbohydrate intake during exercise maintains high levels of carbohydrate oxidation, prevents hypoglycemia, and has a positive effect on the central nervous system. Recent research has focused on athletes training with low carbohydrate availability to enhance metabolic adaptations, but whether this leads to an improvement in performance is unclear. The benefits of protein intake throughout the day following exercise are now well recognized. Athletes should aim to maintain adequate levels of hydration, and they should minimize fluid losses during exercise to no more than 2% of their body weight. Supplement use is widespread in athletes, with recent interest in the beneficial effects of nitrate, beta-alanine, and vitamin D on performance. However, an unregulated supplement industry and inadvertent contamination of supplements with banned substances increases the risk of a positive doping result. Although the availability of nutrition information for athletes varies, athletes will benefit from the advice of a registered dietician or nutritionist.

The influence of hydration status during prolonged endurance exercise on salivary antimicrobial proteins

PURPOSE

Antimicrobial proteins (AMPs) in saliva including secretory immunoglobulin A (SIgA), lactoferrin (SLac) and lysozyme (SLys) are important in host defence against oral and respiratory infections. This study investigated the effects of hydration status on saliva AMP responses to endurance exercise.

METHODS

Using a randomized design, 10 healthy male participants (age 23 ± 4 years, [Formula: see text] 56.8 ± 6.5 ml/kg/min) completed 2 h cycling at 60 % [Formula: see text] in states of euhydration (EH) or dehydration (DH) induced by 24 h fluid restriction. Unstimulated saliva samples were collected before, during, immediately post-exercise and each hour for 3 h recovery.

RESULTS

Fluid restriction resulted in a 1.5 ± 0.5 % loss of body mass from baseline and a 4.3 ± 0.7 % loss immediately post-exercise. Pre-exercise urine osmolality was higher in DH than EH and overall, saliva flow rate was reduced in DH compared with EH (p < 0.05). Baseline SIgA secretion rates were not different between conditions; however, exercise induced a significant increase in SIgA concentration in DH (161 ± 134 to 309 ± 271 mg/L) which remained elevated throughout 3 h recovery. SLac secretion rates increased from pre- to post-exercise in both conditions which remained elevated in DH only. Overall, SLac concentrations were higher in DH than EH. Pre-exercise SLys concentrations were lower in DH compared with EH (1.6 ± 2.0 vs. 5.5 ± 6.7 mg/L). Post-exercise SLys concentrations remained elevated in DH but returned to pre-exercise levels by 1 h post-exercise in EH.

CONCLUSIONS

Exercise in DH caused a reduction in saliva flow rate yet induced greater secretion rates of SLac and higher concentrations of SIgA and SLys. Thus, DH does not impair saliva AMP responses to endurance exercise.

Caffeine and diuresis during rest and exercise: A meta-analysis

OBJECTIVES

Although ergogenic, acute caffeine ingestion may increase urine volume, prompting concerns about fluid balance during exercise and sport events. This meta-analysis evaluated caffeine induced diuresis in adults during rest and exercise.

DESIGN

Meta-analysis.

METHODS

A search of three databases was completed on November 1, 2013. Only studies that involved healthy adults and provided sufficient information concerning the effect size (ES) of caffeine ingestion on urine volume were included. Sixteen studies met the inclusion criteria, providing a total of 28 ESs for the meta-analysis. Heterogeneity was assessed using a random-effects model.

RESULTS

The median caffeine dosage was 300 mg. The overall ES of 0.29 (95% confidence interval (CI) = 0.11-0.48, p = 0.001) corresponds to an increase in urine volume of 109 ± 195 mL or 16.0 ± 19.2% for caffeine ingestion vs. non-caffeine conditions. Subgroup meta-analysis confirmed exercise as a strong moderator: active ES = 0.10, 95% CI = -0.07 to 0.27, p = 0.248 vs. resting ES = 0.54, 95% CI = 0.22-0.85, p = 0.001 (Cochran's Q, p = 0.019). Females (ES = 0.75, 95% CI = 0.38-1.13, p < 0.001) were more susceptible to diuretic effects than males (ES = 0.13, 95% CI = -0.05 to 0.31, p = 0.158) (Cochran's Q, p = 0.003).

CONCLUSIONS

Caffeine exerted a minor diuretic effect which was negated by exercise. Concerns regarding unwanted fluid loss associated with caffeine consumption are unwarranted particularly when ingestion precedes exercise.

Single and combined effects of beetroot juice and caffeine supplementation on cycling time trial performance

Both caffeine and beetroot juice have ergogenic effects on endurance cycling performance. We investigated whether there is an additive effect of these supplements on the performance of a cycling time trial (TT) simulating the 2012 London Olympic Games course. Twelve male and 12 female competitive cyclists each completed 4 experimental trials in a double-blind Latin square design. Trials were undertaken with a caffeinated gum (CAFF) (3 mg·kg(-1) body mass (BM), 40 min prior to the TT), concentrated beetroot juice supplementation (BJ) (8.4 mmol of nitrate (NO3(-)), 2 h prior to the TT), caffeine plus beetroot juice (CAFF+BJ), or a control (CONT). Subjects completed the TT (females: 29.35 km; males: 43.83 km) on a laboratory cycle ergometer under conditions of best practice nutrition: following a carbohydrate-rich pre-event meal, with the ingestion of a carbohydrate-electrolyte drink and regular oral carbohydrate contact during the TT. Compared with CONT, power output was significantly enhanced after CAFF+BJ and CAFF (3.0% and 3.9%, respectively, p < 0.01). There was no effect of BJ supplementation when used alone (-0.4%, p = 0.6 compared with CONT) or when combined with caffeine (-0.9%, p = 0.4 compared with CAFF). We conclude that caffeine (3 mg·kg(-1) BM) administered in the form of a caffeinated gum increased cycling TT performance lasting ∼50-60 min by ∼3%-4% in both males and females. Beetroot juice supplementation was not ergogenic under the conditions of this study.