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Rebelo-Marques A, Coelho-Ribeiro B, De Sousa Lages A, Andrade R, Afonso J, Pereira R, Batista AS, Teixeira VH, Jácome C. Trends and Missing Links in (De)Hydration Research: A Narrative Review. Nutrients 2024; 16:1709. [PMID: 38892642 PMCID: PMC11174495 DOI: 10.3390/nu16111709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Despite decades of literature on (de)hydration in healthy individuals, many unanswered questions remain. To outline research and policy priorities, it is fundamental to recognize the literature trends on (de)hydration and identify current research gaps, which herein we aimed to pinpoint. From a representative sample of 180 (de)hydration studies with 4350 individuals, we found that research is mainly limited to small-scale laboratory-based sample sizes, with high variability in demographics (sex, age, and level of competition); to non-ecological (highly simulated and controlled) conditions; and with a focus on recreationally active male adults (e.g., Tier 1, non-athletes). The laboratory-simulated environments are limiting factors underpinning the need to better translate scientific research into field studies. Although, consistently, dehydration is defined as the loss of 2% of body weight, the hydration status is estimated using a very heterogeneous range of parameters. Water is the most researched hydration fluid, followed by alcoholic beverages with added carbohydrates (CHO). The current research still overlooks beverages supplemented with proteins, amino acids (AA), and glycerol. Future research should invest more effort in "real-world" studies with larger and more heterogeneous cohorts, exploring the entire available spectrum of fluids while addressing hydration outcomes more harmoniously.
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Affiliation(s)
- Alexandre Rebelo-Marques
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal
- Magismed Innovation Institute, 4710-353 Braga, Portugal
| | - Bruna Coelho-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, 4806-909 Guimarães, Portugal
| | | | - Renato Andrade
- Clínica Espregueira—FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Rogério Pereira
- Clínica Espregueira—FIFA Medical Centre of Excellence, 4350-415 Porto, Portugal
- Dom Henrique Research Centre, 4350-415 Porto, Portugal
- Higher School of Health Fernando Pessoa, 4200-253 Porto, Portugal
| | | | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sports, University of Porto, FADEUP, 4200-540 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, ITR, 4050-600 Porto, Portugal
| | - Cristina Jácome
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
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Otsuka J, Okamoto Y, Enoki Y, Maejima D, Fujii N, Kenny GP, Mündel T, Cotter JD, Amano T. Effects of ingesting beverages containing glycerol and sodium with isomaltulose or sucrose on fluid retention in young adults: a single-blind, randomized crossover trial. Appl Physiol Nutr Metab 2024; 49:667-679. [PMID: 38377479 DOI: 10.1139/apnm-2023-0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
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).
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Affiliation(s)
- Junto Otsuka
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Yumi Okamoto
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Yasuaki Enoki
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
| | - Daisuke Maejima
- Advanced Research Institutes, Bourbon Corporation, Niigata, Japan
| | - Naoto Fujii
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Toby Mündel
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Tatsuro Amano
- Laboratory for Exercise and Environment Physiology, Faculty of Education, Niigata University, Niigata, Japan
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Elma Ö, Tümkaya Yılmaz S, Nijs J, Clarys P, Coppieters I, Mertens E, Malfliet A, Deliens T. Impaired Carbohydrate Metabolism among Women with Chronic Low Back Pain and the Role of Dietary Carbohydrates: A Randomized Controlled Cross-Over Experiment. J Clin Med 2024; 13:2155. [PMID: 38610920 PMCID: PMC11012557 DOI: 10.3390/jcm13072155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Impaired glucose regulation is suggested to be related to chronic low back pain (CLBP), although it is not clear how they interact with each other. Thus, the primary aim of this study was to investigate differences in postprandial glycemic responses (PPGRs) (the first sign of impaired glucose metabolism) to high- (sucrose) and low-glycemic index (GI) (isomaltulose) beverages in normoglycemic women with CLBP and healthy controls (HCs) and explore whether any group that showed greater PPGRs to high-GI beverage intake would benefit when the high-GI beverage was replaced with a low-GI beverage. Secondly, this study aimed to explore the association between PPGR and pain in patients with CLBP. Methods: This study was registered at clinicaltrials.org (NCT04459104) before the start of the study. In this study, 53 CLBP patients and 53 HCs were recruited. After 11-12 h of fasting, each participant randomly received isomaltulose or sucrose. Blood glucose levels were measured during the fasting state and 15, 30, 45, 60, 90, and 120 min after the beverage intake, and each participant underwent experimental pain measures. Results: Compared to the HCs, the CLBP group showed significantly higher PPGRs to sucrose (p < 0.021). Additionally, the CLBP group showed a significantly higher decrease in PPGR (p = 0.045) when comparing PPGR to sucrose with PPGR to isomaltulose. Correlation analysis revealed a positive association between self-reported pain sensitivity and PPGR to sucrose, while there was no association found between any experimental pain measures and glycemic responses. Conclusions: Overall, these findings suggest that normoglycemic CLBP patients might have a higher risk of developing impaired glucose tolerance than the HCs and might benefit more when high-GI foods are replaced with low-GI ones.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Physiotherapy Unit, Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Sevilay Tümkaya Yılmaz
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
| | - Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussel, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Peter Clarys
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
| | - Iris Coppieters
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussel, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Evelien Mertens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
- Nutrition and Dietetics Program, Department of Health Care, Design and Technology, Erasmushogeschool Brussel, 1090 Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Tom Deliens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
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Pérez-Castillo ÍM, Williams JA, López-Chicharro J, Mihic N, Rueda R, Bouzamondo H, Horswill CA. Compositional Aspects of Beverages Designed to Promote Hydration Before, During, and After Exercise: Concepts Revisited. Nutrients 2023; 16:17. [PMID: 38201848 PMCID: PMC10781183 DOI: 10.3390/nu16010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
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.
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Affiliation(s)
| | | | | | - Niko Mihic
- Real Madrid, Medical Services, 28055 Madrid, Spain; (J.L.-C.); (N.M.)
| | | | | | - Craig A. Horswill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60608, USA;
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Takada S, Otsuka J, Okamoto Y, Watanabe D, Aoki M, Fujii N, Kenny GP, Enoki Y, Maejima D, Amano T. Effects of ingestion of isomaltulose beverage on plasma volume and thermoregulatory responses during exercise in the heat. Eur J Appl Physiol 2022; 122:2615-2626. [DOI: 10.1007/s00421-022-05044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
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