Comparing the rehydration potential of different milk-based drinks to a carbohydrate-electrolyte beverage

Fluid and electrolyte balance following consumption of skimmed milk and a plant-based soya beverage at rest in euhydrated males

PURPOSE

Cow's milk is one of the most hydrating beverages, but many individuals choose not to consume dairy in their diet due to intolerance, allergy, or dietary preference. Milk is commonly replaced with plant-based beverages, including soya which has the most comparable protein content, but little is known about their hydration potential. This study compared fluid and electrolyte balance responses between a soya beverage and skimmed cow's milk.

METHODS

Ten healthy males [age 27 (6) y; body mass index 24.6 (2.3) kg/m2] completed two randomised counterbalanced trials, involving consuming 1000 mL water from approximately isocaloric amounts of skimmed cow's milk (MILK) or a sweetened soya beverage (SOYA), in four aliquots over 30 min in a euhydrated fasted state. Volume, specific gravity, and electrolyte (sodium, potassium, chloride) concentrations were determined in total-void urine samples collected pre-/post-beverage ingestion, and hourly for 180 min thereafter. Hunger, thirst, nausea and stomach fullness were rated proximal to urine samples.

RESULTS

Total urine mass (MILK, 986 ± 254 g; SOYA, 950 ± 248 g; P = 0.435) and urine specific gravity (P = 0.156) did not differ between trials. Potassium balance was greater in SOYA 0-180 min post-beverage (P ≤ 0.013), whilst chloride balance was greater in MILK 0-120 min post-beverage (P ≤ 0.036). Sodium balance (P = 0.258), total electrolyte balance (P = 0.258), and subjective measures (P ≥ 0.139) were not different between trials.

CONCLUSION

Replacing cow's milk with a soya beverage did not negatively impact fluid balance in healthy young males, making it a viable option for those who choose not to consume dairy in their diet.

Skimmed, Lactose-Free Milk Ingestion Postexercise: Rehydration Effectiveness and Gastrointestinal Disturbances Versus Water and a Sports Drink in Physically Active People

Postexercise hydration is fundamental to replace fluid loss from sweat. This study evaluated rehydration and gastrointestinal (GI) symptoms for each of three beverages: water (W), sports drink (SD), and skimmed, lactose-free milk (SLM) after moderate-intensity cycling in the heat. Sixteen college students completed three exercise sessions each to lose ≈2% of their body mass. They drank 150% of body mass loss of the drink assigned in randomized order; net fluid balance, diuresis, and GI symptoms were measured and followed up for 3 hr after completion of fluid intake. SLM showed higher fluid retention (∼69%) versus W (∼40%; p < .001); SD (∼56%) was not different from SLM or W (p > .05). Net fluid balance was higher for SLM (-0.26 kg) and SD (-0.42 kg) than W (-0.67 kg) after 3 hr (p < .001), resulting from a significantly lower diuresis with SLM. Reported GI disturbances were mild and showed no difference among drinks (p > .05) despite ingestion of W (1,992 ± 425 ml), SD (1,999 ± 429 ml), and SLM (1,993 ± 426 ml) in 90 min. In conclusion, SLM was more effective than W for postexercise rehydration, showing greater fluid retention for the 3-hr follow-up and presenting with low-intensity GI symptoms similar to those with W and SD. These results confirm that SLM is an effective option for hydration after exercise in the heat.

Trends and Missing Links in (De)Hydration Research: A Narrative Review

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.

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.

Sensory Perception of an Oral Rehydration Solution during Exercise in the Heat

Prolonged exercise in the heat elicits a number of physiological changes as glycogen stores are low and water and electrolytes are lost through sweat. However, it is unclear whether these changes provoke an increase in liking of saltiness and, therefore, palatability of an oral rehydration solution (ORS). Twenty-seven recreationally active participants (n = 13 males; n = 14 females) completed sensory analysis of an ORS, a traditional sports drink (TS), and a flavored water placebo (PL) at rest and during 60 min (3 × 20-min bouts) of cycling exercise at 70% age-predicted maximum heart rate (HR_max) at 35.3 ± 1.4 °C and 41 ± 6% relative humidity. Before and after every 20 min of exercise, drinks were rated (using 20-mL beverage samples) based on liking of sweetness, liking of saltiness, thirst-quenching ability, and overall liking on a nine-point hedonic scale. Hydration status was assessed by changes in semi-nude body mass, saliva osmolality (S_Osm), and saliva total protein concentration (S_PC). After 60 min of exercise, participants lost 1.36 ± 0.39% (mean ± SD) of body mass and there were increases in S_Osm and S_PC. At all time points, liking of sweetness, saltiness, thirst-quenching ability, and overall liking was higher for the TS and PL compared to the ORS (p < 0.05). However, the saltiness liking and thirst-quenching ability of the ORS increased after 60 min of exercise compared to before exercise (p < 0.05). There was also a change in predictors of overall liking with pre-exercise ratings mostly determined by liking of sweetness, saltiness, and thirst-quenching ability (p < 0.001), whereas only liking of saltiness predicted overall liking post-exercise (R² = 0.751; p < 0.001). There appears to be a hedonic shift during exercise in which the perception of saltiness becomes the most important predictor of overall liking. This finding supports the potential use of an ORS as a valuable means of hydration during the latter stages of prolonged and/or intense exercise in the heat.

Assessing Overall Exercise Recovery Processes Using Carbohydrate and Carbohydrate-Protein Containing Recovery Beverages

We compared the impact of two different, but commonly consumed, beverages on integrative markers of exercise recovery following a 2 h high intensity interval exercise (i.e., running 70-80% V̇O2 max intervals and interspersed with plyometric jumps). Participants (n = 11 males, n = 6 females) consumed a chocolate flavored dairy milk beverage (CM: 1.2 g carbohydrate/kg BM and 0.4 g protein/kg BM) or a carbohydrate-electrolyte beverage (CEB: isovolumetric with 0.76 g carbohydrate/kg BM) after exercise, in a randomized-crossover design. The recovery beverages were provided in three equal boluses over a 30 min period commencing 1 h post-exercise. Muscle biopsies were performed at 0 h and 2 h in recovery. Venous blood samples, nude BM and total body water were collected before and at 0, 2, and 4 h recovery. Gastrointestinal symptoms and breath hydrogen (H2) were collected before exercise and every 30 min during recovery. The following morning, participants returned for performance assessment. In recovery, breath H2 reached clinical relevance of >10 ppm following consumption of both beverages, in adjunct with high incidence of gastrointestinal symptoms (70%), but modest severity. Blood glucose response was greater on CEB vs. CM (P < 0.01). Insulin response was greater on CM compared with CEB (P < 0.01). Escherichia coli lipopolysaccharide stimulated neutrophil function reduced on both beverages (49%). p-GSK-3β/total-GSK-3β was greater on CM compared with CEB (P = 0.037); however, neither beverage achieved net muscle glycogen re-storage. Phosphorylation of mTOR was greater on CM than CEB (P < 0.001). Fluid retention was lower (P = 0.038) on CEB (74.3%) compared with CM (82.1%). Physiological and performance outcomes on the following day did not differ between trials. Interconnected recovery optimization markers appear to respond differently to the nutrient composition of recovery nutrition, albeit subtly and with individual variation. The present findings expand on recovery nutrition strategies to target functionality and patency of the gastrointestinal tract as a prerequisite to assimilation of recovery nutrition, as well as restoration of immunocompetency.

Does the Nutritional Composition of Dairy Milk Based Recovery Beverages Influence Post-exercise Gastrointestinal and Immune Status, and Subsequent Markers of Recovery Optimisation in Response to High Intensity Interval Exercise?

This study aimed to determine the effects of flavored dairy milk based recovery beverages of different nutrition compositions on markers of gastrointestinal and immune status, and subsequent recovery optimisation markers. After completing 2 h high intensity interval running, participants (n = 9) consumed a whole food dairy milk recovery beverage (CM, 1.2 g/kg body mass (BM) carbohydrate and 0.4 g/kg BM protein) or a dairy milk based supplement beverage (MBSB, 2.2 g/kg BM carbohydrate and 0.8 g/kg BM protein) in a randomized crossover design. Venous blood samples, body mass, body water, and breath samples were collected, and gastrointestinal symptoms (GIS) were measured, pre- and post-exercise, and during recovery. Muscle biopsies were performed at 0 and 2 h of recovery. The following morning, participants returned to the laboratory to assess performance outcomes. In the recovery period, carbohydrate malabsorption (breath H2 peak: 49 vs. 24 ppm) occurred on MBSB compared to CM, with a trend toward greater gut discomfort. No difference in gastrointestinal integrity (i.e., I-FABP and sCD14) or immune response (i.e., circulating leukocyte trafficking, bacterially-stimulated neutrophil degranulation, and systemic inflammatory profile) markers were observed between CM and MBSB. Neither trial achieved a positive rate of muscle glycogen resynthesis [-25.8 (35.5) mmol/kg dw/h]. Both trials increased phosphorylation of intramuscular signaling proteins. Greater fluid retention (total body water: 86.9 vs. 81.9%) occurred on MBSB compared to CM. Performance outcomes did not differ between trials. The greater nutrient composition of MBSB induced greater gastrointestinal functional disturbance, did not prevent the post-exercise reduction in neutrophil function, and did not support greater overall acute recovery.

Influence of Nutrient Intake on 24 Hour Urinary Hydration Biomarkers Using a Clustering-Based Approach

Previous work focusing on understanding nutrient intake and its association with total body water homeostasis neglects to consider the collinearity of types of nutrients consumed and subsequent associations with hydration biomarkers. Therefore, the purpose of this study was to analyze consumption patterns of 23 a priori selected nutrients involved in osmotic homeostasis, as well as their association with 24 h urinary hydration markers among fifty African–American first-year college students through a repeated measures observation in a daily living setting. Through application of hierarchical clustering, we were able to identity four clusters of nutrients based on 24 h dietary recalls: (1) alcohol + pinitol, (2) water + calcium + magnesium + erythritol + inositol + sorbitol + xylitol, (3) total calories + total fat + total protein + potassium + sodium + zinc + phosphorous + arginine, and (4) total carbohydrates + total fiber + soluble fiber + insoluble fiber + mannitol + betaine. Furthermore, we found that consumption of nutrients in Cluster #2 was significantly predictive of urine osmolality (p = 0.004); no other clusters showed statistically significant associations with 24 h urinary hydration biomarkers. We conclude that there may be some nutrients that are commonly consumed concomitantly (at the day level), across a variety of settings and populations, and that a limited subset of the clustering of these nutrients may associate with body water status.

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

Milk permeate is an electrolyte-rich, protein- and fat-free liquid with a similar carbohydrate and mineral content to that of milk. Its hydration efficacy has not been examined. The beverage hydration index (BHI) has been used to compare various beverages to water in terms of post-ingestion fluid balance and retention. Our purpose was to compare the BHI (and related physiological responses) of a novel milk permeate solution (MPS) to that of water and a traditional carbohydrate–electrolyte solution (CES). Over three visits, 12 young subjects consumed 1 L of water, CES, or MPS. Urine samples were collected immediately post-ingestion and at 60, 120, 180, and 240 min. BHI was calculated by dividing cumulative urine output after water consumption by cumulative urine output for each test beverage at each time point. The BHI for MPS was significantly higher at all time points compared to water (all p < 0.001) and CES (all p ≤ 0.01) but did not differ between CES and water at any time point. Drinking 1 L of MPS resulted in decreased cumulative urine output across the subsequent 4 h compared to water and CES, suggesting that a beverage containing milk permeate is superior to water and a traditional CES at sustaining positive fluid balance post-ingestion.

Impact of Nutrient Intake on Hydration Biomarkers Following Exercise and Rehydration Using a Clustering-Based Approach

We investigated the impact of nutrient intake on hydration biomarkers in cyclists before and after a 161 km ride, including one hour after a 650 mL water bolus consumed post-ride. To control for multicollinearity, we chose a clustering-based, machine learning statistical approach. Five hydration biomarkers (urine color, urine specific gravity, plasma osmolality, plasma copeptin, and body mass change) were configured as raw- and percent change. Linear regressions were used to test for associations between hydration markers and eight predictor terms derived from 19 nutrients merged into a reduced-dimensionality dataset through serial k-means clustering. Most predictor groups showed significant association with at least one hydration biomarker: (1) Glycemic Load + Carbohydrates + Sodium, (2) Protein + Fat + Zinc, (3) Magnesium + Calcium, (4) Pinitol, (5) Caffeine, (6) Fiber + Betaine, and (7) Water; potassium + three polyols, and mannitol + sorbitol showed no significant associations with any hydration biomarker. All five hydration biomarkers were associated with at least one nutrient predictor in at least one configuration. We conclude that in a real-life scenario, some nutrients may serve as mediators of body water, and urine-specific hydration biomarkers may be more responsive to nutrient intake than measures derived from plasma or body mass.

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.

Cola Beverages: Clinical Uses versus Adverse Effects

Methods:

In this systematic review we tried to explore these new uses for practitioners and also reemphasize on the most evidence-based complications of cola consumption like bone loss and metabolic and cardiovascular adverse effects in cases of misuse and overuse from both clinical and nutritional points of view via searching the PubMed database.

Results:

We chose 145 journal articles from the most relevant ones plus 30 extra references and categorized their topics in two classes of medical uses and adverse effects.

Conclusion:

It could be stated that cola beverages have demonstrated interesting uses and benefits in medicine but their use should be regulated as strict as possible.

Analysis of 2009⁻2012 Nutrition Health and Examination Survey (NHANES) Data to Estimate the Median Water Intake Associated with Meeting Hydration Criteria for Individuals Aged 12⁻80 in the US Population

In 2005, US water intake recommendations were based on analyses of Nutrition Health and Examination Surveys (NHANES) III data that examined if hydration classification varied by water intake and estimated the median water intake associated with hydration in persons aged 19–30. Given the upcoming 2020–2025 Dietary Guidelines review, this analysis addressed the same two aims with 2009–2012 NHANES data. Methods were updated by defining hydration criteria in terms of multiple measures (serum sodium 135–144 mmol/L and urine osmolality < 500 mmol/kg), expressing water intake as ml/kg, distinguishing plain water intake (PWI) from total water intake (TWI), using weighted age- and sex-specific multivariable models to control for determinants of water intake requirements, and selecting two study samples (the non-acutely ill US population and a sub-group without selected chronic disease risk factors). In the US population and sub-group, the relative risk (RR) of meeting the hydration criteria was significantly greater for individuals with TWI ≥ 45 mL/kg or PWI ≥ 20 mL/kg (for the US population 19–50 years of age: adjusted RR = 1.36, 95% CI: 1.10–1.68 for males; adjusted RR = 1.70, 95% CI: 1.49–1.95 for females. For the sub-group 51–70 years of age: adjusted RR = 2.20, 95% CI: 1.15–4.18 for males; adjusted RR = 2.00, 95% CI: 1.18–3.40 for females). The median (SE) TWI and PWI associated with meeting the hydration criteria for males and females 19–50 years of age were 42 (2) mL/kg and 14 (1) mL/kg and 43 (2) mL/kg and 16 (1) mL/kg, respectively. The significant association between water intake and hydration classification differs from the null association underlying the 2005 water intake recommendations and may lead to different reasoning and inferences for the 2020–2025 Dietary Guidelines.

The effect of different post-exercise beverages with food on ad libitum fluid recovery, nutrient provision, and subsequent athletic performance

This study investigated the effect of consuming either water or a carbohydrate (CHO)-electrolyte sports beverage ('Sports Drink') ad libitum with food during a 4 h post-exercise recovery period on fluid restoration, nutrient provision and subsequent endurance cycling performance. On two occasions, 16 endurance-trained cyclists; 8 male [M] (age: 31 ± 9 y; VO_2max: 54 ± 6 mL·kg^-1·min^-1) and 8 female [F] (age: 33 ± 8 y; VO_2max: 50 ± 7 mL·kg^-1·min^-1); lost 2.3 ± 0.3% and 1.6 ± 0.3% of their body mass (BM), respectively during 1 h of fixed-intensity cycling. Participants then had ad libitum access to either Water or Sports Drink and food for the first 195 min of a 4 h recovery period. At the conclusion of the recovery period, participants completed a cycling performance test consisting of a 45 min fixed-intensity pre-load and an incremental test to volitional exhaustion (peak power output, PPO). Beverage intake; total water/nutrient intake; and indicators of fluid recovery (BM, urine output, plasma osmolality [P_OSM]) were assessed periodically throughout trials. Participants returned to a similar state of net positive fluid balance prior to recommencing exercise, regardless of the beverage provided (Water: +0.4 ± 0.5 L; Sports Drink: +0.3 ± 0.3 L, p = 0.529). While Sports Drink increased post-exercise energy (M: +1.8 ± 1.0 MJ; F: +1.3 ± 0.5 MJ) and CHO (M: +114 ± 31 g; F: +84 ± 25 g) intake (i.e. total from food and beverage) (p's < 0.001), this did not improve subsequent endurance cycling performance (Water: 337 ± 40 W [M] and 252 ± 50 W [F]; Sports Drink: 340 ± 40 W [M] and 258 ± 47 W [F], p = 0.242). Recovery beverage recommendations should consider the post-exercise environment (i.e. the availability of food), an individual's tolerance for food and fluid pre-/post-exercise, the immediate requirements for refuelling (i.e. CHO demands of the activity) and the athlete's overall dietary goals.

Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview

Team sport athletes face a variety of nutritional challenges related to recovery during the competitive season. The purpose of this article is to review nutrition strategies related to muscle regeneration, glycogen restoration, fatigue, physical and immune health, and preparation for subsequent training bouts and competitions. Given the limited opportunities to recover between training bouts and games throughout the competitive season, athletes must be deliberate in their recovery strategy. Foundational components of recovery related to protein, carbohydrates, and fluid have been extensively reviewed and accepted. Micronutrients and supplements that may be efficacious for promoting recovery include vitamin D, omega-3 polyunsaturated fatty acids, creatine, collagen/vitamin C, and antioxidants. Curcumin and bromelain may also provide a recovery benefit during the competitive season but future research is warranted prior to incorporating supplemental dosages into the athlete's diet. Air travel poses nutritional challenges related to nutrient timing and quality. Incorporating strategies to consume efficacious micronutrients and ingredients is necessary to support athlete recovery in season.

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.

Effects of whey protein in carbohydrate-electrolyte drinks on post-exercise rehydration

The purpose of this study was to examine the effects of different amounts of whey protein in carbohydrate-electrolyte (CE) drinks on post-exercise rehydration. Ten males completed 5 trials in a randomised cross-over design. A 4-h recovery was applied after a 60-min run at 65% VO_2peak in each trial. During recovery, the participants ingested a high-carbohydrate CE drink (CE-H), a low-carbohydrate CE drink (CE-L), a high-whey-protein (33 g·L^-1) CE drink (CW-H), a medium-whey-protein (22 g·L^-1) CE drink (CW-M) or a low-whey-protein (15 g·L^-1) CE drink (CW-L) in a volume equivalent to 150% of their body mass (BM) loss. The drinks were provided in six equal boluses and consumed by the participants within 150 min in each trial. After exercise, a BM loss of 2.15% ± 0.05% was achieved. Urine production was less in the CW-M and CW-H trials during recovery, which induced a greater fluid retention in the CW-M (51.0% ± 5.7%) and CW-H (55.4% ± 3.8%) trials than in any other trial (p < .05). The plasma albumin content was higher in the CW-H trial than in the CE-H and CE-L trials at 2 h (p < .05) and 3 h (p < .01) during recovery. The aldosterone concentration was lower in the CE-H trial than in the CW-M and CW-H trials after recovery (p < .05). It is concluded that the rehydration was improved when whey protein was co-ingested with CE drinks during a 4-h recovery after a 60-min run. However, this additive effect was only observed when whey protein concentration was at least 22 g·L^-1 in the current study.

Milk: An Effective Recovery Drink for Female Athletes

Milk has become a popular post-exercise recovery drink. Yet the evidence for its use in this regard comes from a limited number of investigations utilising very specific exercise protocols, and mostly with male participants. Therefore, the aim of this study was to investigate the effects of post-exercise milk consumption on recovery from a sprinting and jumping protocol in female team-sport athletes. Eighteen females participated in an independent-groups design. Upon completion of the protocol participants consumed 500 mL of milk (MILK) or 500 mL of an energy-matched carbohydrate (CHO) drink. Muscle function (peak torque, rate of force development (RFD), countermovement jump (CMJ), reactive strength index (RSI), sprint performance), muscle soreness and tiredness, symptoms of stress, serum creatine kinase (CK) and high-sensitivity C-reactive protein (hsCRP) were determined pre- and 24 h, 48 h and 72 h post-exercise. MILK had a very likely beneficial effect in attenuating losses in peak torque (180°/s) from baseline to 72 h (0.0 ± 10.0% vs. −8.7 ± 3.7%, MILK v CHO), and countermovement jump (−1.1 ± 5.2% vs. −10.4 ± 6.7%) and symptoms of stress (−13.5 ± 7.4% vs. −18.7 ± 11.0%) from baseline to 24 h. MILK had a likely beneficial effect and a possibly beneficial effect on other peak torque measures and 5 m sprint performance at other timepoints but had an unclear effect on 10 and 20 m sprint performance, RSI, muscle soreness and tiredness, CK and hsCRP. In conclusion, consumption of 500 mL milk attenuated losses in muscle function following repeated sprinting and jumping and thus may be a valuable recovery intervention for female team-sport athletes following this type of exercise.

Achieving Optimal Post-Exercise Muscle Protein Remodeling in Physically Active Adults through Whole Food Consumption

Dietary protein ingestion is critical to maintaining the quality and quantity of skeletal muscle mass throughout adult life. The performance of acute exercise enhances muscle protein remodeling by stimulating protein synthesis rates for several hours after each bout, which can be optimized by consuming protein during the post-exercise recovery period. To date, the majority of the evidence regarding protein intake to optimize post-exercise muscle protein synthesis rates is limited to isolated protein sources. However, it is more common to ingest whole food sources of protein within a normal eating pattern. Emerging evidence demonstrates a promising role for the ingestion of whole foods as an effective nutritional strategy to support muscle protein remodeling and recovery after exercise. This review aims to evaluate the efficacy of the ingestion of nutrient-rich and protein-dense whole foods to support post-exercise muscle protein remodeling and recovery with pertinence towards physically active people.

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

OBJECTIVE

  To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals.

BACKGROUND

  Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals.

RECOMMENDATIONS

  Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

The Effect of Fluid Intake Following Dehydration on Subsequent Athletic and Cognitive Performance: a Systematic Review and Meta-analysis

Background

The deleterious effects of dehydration on athletic and cognitive performance have been well documented. As such, dehydrated individuals are advised to consume fluid in volumes equivalent to 1.25 to 1.5 L kg⁻¹ body mass (BM) lost to restore body water content. However, individuals undertaking subsequent activity may have limited time to consume fluid. Within this context, the impact of fluid intake practices is unclear. This systematic review investigated the effect of fluid consumption following a period of dehydration on subsequent athletic and cognitive performance.

Methods

PubMed (MEDLINE), Web of Science (via Thomas Reuters) and Scopus databases were searched for articles reporting on athletic (categorized as: continuous, intermittent, resistance, sport-specific and balance exercise) or cognitive performance following dehydration of participants under control (no fluid) and intervention (fluid intake) conditions. Meta-analytic procedures determined intervention efficacy for continuous exercise performance.

Results

Sixty-four trials (n = 643 participants) derived from 42 publications were reviewed. Dehydration decreased BM by 1.3–4.2%, and fluid intake was equivalent to 0.4–1.55 L kg⁻¹ BM lost. Fluid intake significantly improved continuous exercise performance (22 trials), Hedges’ g = 0.46, 95% CI 0.32, 0.61. Improvement was greatest when exercise was performed in hotter environments and over longer durations. The volume or timing of fluid consumption did not influence the magnitude of this effect. Evidence indicating a benefit of fluid intake on intermittent (10 trials), resistance (9 trials), sport-specific (6 trials) and balance (2 trials) exercise and on cognitive performance (15 trials) was less apparent and requires further elucidation.

Conclusions

Fluid consumption following dehydration may improve continuous exercise performance under heat stress conditions, even when the body water deficit is modest and fluid intake is inadequate for complete rehydration.

Electronic supplementary material

The online version of this article (doi:10.1186/s40798-017-0079-y) contains supplementary material, which is available to authorized users.

Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration

Hypohydration, or a body water deficit, is a common occurrence in athletes and recreational exercisers following the completion of an exercise session. For those who will undertake a further exercise session that day, it is important to replace water losses to avoid beginning the next exercise session hypohydrated and the potential detrimental effects on performance that this may lead to. The aim of this review is to provide an overview of the research related to factors that may affect postexercise rehydration. Research in this area has focused on the volume of fluid to be ingested, the rate of fluid ingestion, and fluid composition. Volume replacement during recovery should exceed that lost during exercise to allow for ongoing water loss; however, ingestion of large volumes of plain water results in a prompt diuresis, effectively preventing longer-term maintenance of water balance. Addition of sodium to a rehydration solution is beneficial for maintenance of fluid balance due to its effect on extracellular fluid osmolality and volume. The addition of macronutrients such as carbohydrate and protein can promote maintenance of hydration by influencing absorption and distribution of ingested water, which in turn effects extracellular fluid osmolality and volume. Alcohol is commonly consumed in the postexercise period and may influence postexercise rehydration, as will the coingestion of food. Future research in this area should focus on providing information related to optimal rates of fluid ingestion, advisable solutions to ingest during different duration recovery periods, and confirmation of mechanistic explanations for the observations outlined.

Fluid, energy and nutrient recovery via ad libitum intake of different fluids and food

INTRODUCTION

This study compared the effects of ad libitum consumption of different beverages and foods on fluid retention and nutrient intake following exercise.

METHODS

Ten endurance trained males (mean±SD; Age=25.3±4.9years, VO₂max=63.0±7.2mL·kg·min^-1) performed four trials employing a counterbalanced, crossover design. Following 60min of exercise (matched for energy expenditure and fluid loss) participants consumed either water (W1 and W2), a sports drink (Powerade® (P)) or a milk-based liquid meal supplement (Sustagen Sport® (SS)) over a four hour recovery period. Additionally, participants had access to snack foods on two occasions within the first 2h of recovery on all trials. All beverages and food were consumed ad libitum. Total nutrient intake, urine volume, USG, body weight as well as subjective measures of gastrointestinal tolerance and thirst were obtained hourly. Plasma osmolality was measured pre, post, 1 and 4h after exercise.

RESULTS

Total fluid volume ingested from food and beverages in W1 (2.28±0.42L) and P (2.82±0.80L) trials were significantly greater than SS (1.94±0.54L). Total urine output was not different between trials (W1=644±202mL, W2=602±352mL, P=879±751mL, SS=466±129mL). No significant differences in net body weight change was observed between trials (W1=0.01±0.28kg, W2=0.08±0.30kg, P=-0.02±0.24kg, SS=-0.05±0.24kg). Total energy intake was higher on P (10,179±1484kJ) and SS (10,577±2210kJ) compared to both water trials (W1=7826±888kJ, W2=7578±1112kJ).

CONCLUSION

With the co-ingestion of food, fluid restoration following exercise is tightly regulated and not influenced by the choice of either water, a carbohydrate-electrolyte (sports drink) or a milk-based beverage.

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.