Evolution of the thirst mechanism in Homo: The need and limitations of thirst and hydration

There is a view that the perception of thirst and actual body fluid balance may affect cognitive and exercise performance. The evolutionary evidence suggests that our survival was dependent on our ability to sweat profusely when hunting during the heat of the day (persistence hunting), so if water deficits were not tolerated, consequently the thirst mechanism would limit our persistence hunting capability. This also means that hunting and searching for water was undertaken with some extent of water deficit, and in turn suggests that performance; physical and cognitive, was conducted with a degree of dehydration. Given the current views on the maintenance of body water for performance, there is a need to evaluate the evidence relating to tolerance limits for water deficits with respect to both physical and cognitive performance. This review considers the thirst mechanism and the conditions and selective pressures under which this might have evolved. Consideration will be given to how the thirst mechanism influences our physical and cognitive performance. The review suggests that Homo developed appropriate tolerances for water deficits and thirst perception, with a safety margin that prevented detrimental declines in physical and cognitive performance to the point of inhibiting corrective action. This would have offered a selective advantage, enabling the search for water and functioning adequately during periods of water scarcity.

Ultra-Cycling- Past, Present, Future: A Narrative Review

BACKGROUND

Ultra-endurance events are gaining popularity in multiple exercise disciplines, including cycling. With increasing numbers of ultra-cycling events, aspects influencing participation and performance are of interest to the cycling community.

MAIN BODY

The aim of this narrative review was, therefore, to assess the types of races offered, the characteristics of the cyclists, the fluid and energy balance during the race, the body mass changes after the race, and the parameters that may enhance performance based on existing literature. A literature search was conducted in PubMed, Scopus, and Google Scholar using the search terms 'ultracycling', 'ultra cycling', 'ultra-cycling', 'ultra-endurance biking', 'ultra-bikers' and 'prolonged cycling'. The search yielded 948 results, of which 111 were relevant for this review. The studies were classified according to their research focus and the results were summarized. The results demonstrated changes in physiological parameters, immunological and oxidative processes, as well as in fluid and energy balance. While the individual race with the most published studies was the Race Across America, most races were conducted in Europe, and a trend for an increase in European participants in international races was observed. Performance seems to be affected by characteristics such as age and sex but not by anthropometric parameters such as skin fold thickness. The optimum age for the top performance was around 40 years. Most participants in ultra-cycling events were male, but the number of female athletes has been increasing over the past years. Female athletes are understudied due to their later entry and less prominent participation in ultra-cycling races. A post-race energy deficit after ultra-cycling events was observed.

CONCLUSION

Future studies need to investigate the causes for the observed optimum race age around 40 years of age as well as the optimum nutritional supply to close the observed energy gap under consideration of the individual race lengths and conditions. Another research gap to be filled by future studies is the development of strategies to tackle inflammatory processes during the race that may persist in the post-race period.

Ad libitum ice slurry ingestion and half-marathon performance in a hot environment: A study comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C

Ice slurry ingestion during prolonged exercises may improve performance in hot environments; however, the ideal amount and timing of ingestion are still uncertain. We determined whether ad libitum ice slurry ingestion influences physiological and perceptual variables and half-marathon performance while comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C. Ten trained participants (28 ± 2 years; mean and SD) were required to run two half marathons while consuming either ice slurry (-1 °C; Ad-1) or water (37 °C; 37 CE) ad libitum. They then performed two other half marathons where, during one, they were required to ingest an amount of water equivalent to the amount consumed during the Ad-1 trial (Pro37), and in the other, to ingest ice slurry in the amount consumed during the 37 CE trial (Pro-1). During the half marathons, dry-bulb temperature and relative humidity were controlled at 33.1 ± 0.3 °C and 60 ± 3%, respectively. Ad-1 ingestion (349.6 ± 58.5 g) was 45% less than 37 CE ingestion (635.5 ± 135.8 g). Physical performance, heart rate, perceived exertion, body temperatures, and thermal perception were not influenced by the temperature or amount of beverage ingestion. However, a secondary analysis suggested that lower beverage ingestion was associated with improved performance (Ad-1 + Pro37 vs. 37 CE + Pro-1: -4.0 min, Cohen's d = 0.39), with a significant relationship between lower beverage ingestion and faster running time (b = 0.02, t = 4.01, p < 0.001). In conclusion, ice slurry ingestion does not affect performance or physiological or perceptual variables during a half marathon in a hot environment. Preliminary evidence suggests that lower beverage ingestion (ice slurry or warm water) is associated with improved performance compared to higher ingestion.

Personalized prediction of optimal water intake in adult population by blended use of machine learning and clinical data

Growing evidence suggests that sustained concentrated urine contributes to chronic metabolic and kidney diseases. Recent results indicate that a daily urinary concentration of 500 mOsm/kg reflects optimal hydration. This study aims at providing personalized advice for daily water intake considering personal intrinsic (age, sex, height, weight) and extrinsic (food and fluid intakes) characteristics to achieve a target urine osmolality (U_Osm) of 500 mOsm/kg using machine learning and optimization algorithms. Data from clinical trials on hydration (four randomized and three non-randomized trials) were analyzed. Several machine learning methods were tested to predict U_Osm. The predictive performance of the developed algorithm was evaluated against current dietary guidelines. Features linked to urine production and fluid consumption were listed among the most important features with relative importance values ranging from 0.10 to 0.95. XGBoost appeared the most performing approach (Mean Absolute Error (MAE) = 124.99) to predict U_Osm. The developed algorithm exhibited the highest overall correct classification rate (85.5%) versus that of dietary guidelines (77.8%). This machine learning application provides personalized advice for daily water intake to achieve optimal hydration and may be considered as a primary prevention tool to counteract the increased incidence of chronic metabolic and kidney diseases.

Post-Exercise Voluntary Drinking Cessation Is Associated with the Normalization of Plasma Osmolality and Thirst Perception, but Not of Urine Indicators or Net Fluid Balance

Post-exercise rehydration has been widely studied, with particular emphasis on retention of ingested fluid; comparatively little research has been conducted on why we drink more or less. To identify physiological values corresponding to voluntary drinking cessation (VDC), nine males exercised intermittently at 70−80% HRmax in the heat (WBGT = 28.1 ± 0.7 °C) to achieve a dehydration of approximately 4.0% body mass (BM). After exercise, participants were instructed to drink water as long and as much as they needed. Urine color (Ucolor), specific gravity (USG), osmolality (Uosm), plasma osmolality (Posm), fullness, BM, and thirst perception (TP) were measured pre- and post-exercise and at VDC. Each variable was compared for the three points in time with a one-way ANOVA. Participants reached dehydration of −3.6 ± 0.3% BM. Pre-exercise USG (1.022 ± 0.004) was lower than at VDC (1.029 ± 0.004, p = 0.022), Uosm did not change over time (p = 0.217), and Ucolor was lower pre-exercise (3.4 ± 0.7) vs. post-exercise (5.5 ± 1.23, p = 0.0008) and vs. VDC (6.3 ± 1.1, p < 0.0001). Posm showed a difference between pre-exercise (289.5 ± 2.3) and post-exercise (297.8 ± 3.9, p = 0.0006) and between post-exercise and VDC (287.3 ± 5.4, p < 0.0001). TP post-exercise (96.4 ± 4.34) was significantly higher than pre-exercise (36.2 ± 19.1) and VDC (25.0 ± 18.2, p < 0.0001). At VDC, participants had recovered 58.7 ± 12.1% of BM loss. At the point of voluntary drinking cessation, Posm and thirst perception had returned to their pre-exercise values, while rehydration relative to initial BM was still incomplete.

Association Between Water Intake and Mortality Risk-Evidence From a National Prospective Study

Background

Few studies have explored the association between water intake and mortality risk, and the findings were inconsistent.

Objective

This study aimed to explore the water intake–mortality association, utilizing the data from the National Health and Nutrition Examination Survey (NHANES) and the 2015 public-linked mortality files released by the National Center for Health Statistics.

Methods

We used the diet- and mortality-linked data of a total of 35,463 adults (17,234 men) aged ≥20 years in the NHANESs 1999–2014 to perform a prospective study. The multivariate-adjusted Cox proportional hazards model was used to explore the associations of the amount of water intake (expressed by total water, plain water, beverage, and food water) and water intake proportion (expressed by the percentage of each kind of water) with mortality risks due to all causes, malignant neoplasms/cancer, and heart disease. The restricted cubic spline plots were adopted to clarify the dose–response relationships among them.

Results

With a median of 88 months (interquartile range: 49–136 months) follow-up, a total of 4,915 all-cause deaths occurred, including 1,073 and 861 deaths from malignant neoplasms/cancer and heart disease, respectively. The amount of water intake in either type was negatively associated with all-cause mortality risk. Additionally, the negative linear dose–response relationships of water intake and all-cause mortality risk were found for all types of water except for food water, which followed a non-linear pattern. Similarly, compared to the lowest quartile (beverage water intake: <676 g/day; food water intake: <532 g/day), beverage and food water intakes in the range of 1,033–1,524 and 1,612–3,802 g/day were associated with decreased malignant neoplasms/cancer mortality risk. A U-shaped dose–response relationship was found for beverage water intake and malignant neoplasms/cancer mortality risk and a negative linear dose–response relationship was found for food water intake and malignant neoplasms/cancer mortality risk. Coffee and/or tea consumption was/were negatively associated with mortality risks due to all causes and malignant neoplasms/cancer. No significant associations of water intake proportion and mortality risks were found.

Conclusion

Our findings demonstrated that higher water intake is associated with lower mortality risks among the United States population.

Changes in Factors Regulating Serum Sodium Homeostasis During Two Ultra-Endurance Mountain Races of Different Distances: 69km vs. 121km

Overdrinking and non-osmotic arginine vasopressin release are the main risk factors for exercise-associated hyponatremia (EAH) in ultra-marathon events. However, particularly during ultra-marathon running in mountainous regions, eccentric exercise and hypoxia, which have been shown to modulate inflammation, hormones regulating fluid homeostasis (hypoxia), and oxidative stress, could contribute to serum sodium changes in a dose-dependent manner. To the best of our knowledge, the contribution of these factors, the extent of which depends on the duration and geographical location of the race, has not been well studied. Twelve male participants (11 finishers) of the short (69km, 4,260m elevation-gain) and 15 male participants (seven finishers) of the long (121km, 7,554m elevation-gain) single-stage Südtirol Ultra Sky-Race took part in this observational field study. Venous blood was drawn immediately before and after the race. Analyses included serum sodium concentration, copeptin (a stable marker for vasopressin), markers of inflammation, muscle damage and oxidative stress. Heart rate was measured during the race and race time was obtained from the race office. During the short and the long competition two and one finishers, respectively showed serum sodium concentrations >145mmol/L. During the long competition, one athlete showed serum sodium concentrations <135mmol/L. Only during the short competition percent changes in serum sodium concentrations of the finishers were related to percent changes in body mass (r=-0.812, p=0.002), total time (r=-0.608, p=0.047) and training impulse (TRIMP) (r=-0.653, p=0.030). Data show a curvilinear (quadratic) relationship between percent changes in serum sodium concentration and body mass with race time when including all runners (short, long, finishers and non-finishers). The observed prevalence of hypo- and hypernatremia is comparable to literature reports, as is the relationship between serum sodium changes and race time, race intensity and body mass changes of the finishers of the short race. The curvilinear relationship indicates that there might be a turning point of changes in serum sodium and body mass changes after a race time of approximately 20h. Since the turning point is represented mainly by non-finishers, regardless of race duration slight decrease in body mass and a slight increase in serum sodium concentration should be targeted to complete the race. Drinking to the dictate of thirst seems an adequate approach to achieve this goal.

Awareness of Fluid Losses Does Not Impact Thirst during Exercise in the Heat: A Double-Blind, Cross-Over Study

Background: Thirst has been used as an indicator of dehydration; however, as a perception, we hypothesized that it could be affected by received information related to fluid losses. The purpose of this study was to identify whether awareness of water loss can impact thirst perception during exercise in the heat. Methods: Eleven males participated in two sessions in random order, receiving true or false information about their fluid losses every 30 min. Thirst perception (TP), actual dehydration, stomach fullness, and heat perception were measured every 30 min during intermittent exercise until dehydrated by ~4% body mass (BM). Post exercise, they ingested water ad libitum for 30 min. Results: Pre-exercise BM, TP, and hydration status were not different between sessions (p > 0.05). As dehydration progressed during exercise, TP increased significantly (p = 0.001), but it was the same for both sessions (p = 0.447). Post-exercise water ingestion was almost identical (p = 0.949) in the two sessions. Conclusion: In this study, thirst was a good indicator of fluid needs during exercise in the heat when no fluid was ingested, regardless of receiving true or false water loss information.

Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies

A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.

Physiological interactions with personal-protective clothing, physically demanding work and global warming: An Asia-Pacific perspective

The Asia-Pacific contains over half of the world's population, 21 countries have a Gross Domestic Product <25% of the world's largest economy, many countries have tropical climates and all suffer the impact of global warming. That 'perfect storm' exacerbates the risk of occupational heat illness, yet first responders must perform physically demanding work wearing personal-protective clothing and equipment. Unfortunately, the Eurocentric emphasis of past research has sometimes reduced its applicability to other ethnic groups. To redress that imbalance, relevant contemporary research has been reviewed, to which has been added information applicable to people of Asian, Melanesian and Polynesian ancestry. An epidemiological triad is used to identify the causal agents and host factors of work intolerance within hot-humid climates, commencing with the size dependency of resting metabolism and heat production accompanying load carriage, followed by a progression from the impact of single-layered clothing through to encapsulating ensembles. A morphological hypothesis is presented to account for inter-individual differences in heat production and heat loss, which seems to explain apparent ethnic- and gender-related differences in thermoregulation, at least within thermally compensable states. The mechanisms underlying work intolerance, cardiovascular insufficiency and heat illness are reviewed, along with epidemiological data from the Asia-Pacific. Finally, evidence-based preventative and treatment strategies are presented and updated concerning moisture-management fabrics and barriers, dehydration, pre- and post-exercise cooling, and heat adaptation. An extensive reference list is provided, with >25 recommendations enabling physiologists, occupational health specialists, policy makers, purchasing officers and manufacturers to rapidly extract interpretative outcomes pertinent to the Asia-Pacific.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Effect of Thirst-Driven Fluid Intake on 1 H Cycling Time-Trial Performance in Trained Endurance Athletes

A meta-analysis demonstrated that programmed fluid intake (PFI) aimed at fully replacing sweat losses during a 1 h high-intensity cycling exercise impairs performance compared with no fluid intake (NFI). It was reported that thirst-driven fluid intake (TDFI) may optimize cycling performance, compared with when fluid is consumed more than thirst dictates. However, how TDFI, compared with PFI and NFI, impacts performance during a 1 h cycling time-trial performance remains unknown. The aim of this study was to compare the effect of NFI, TDFI and PFI on 1 h cycling time-trial performance. Using a randomized, crossover and counterbalanced protocol, 9 (7 males and 2 females) trained endurance athletes (30 ± 9 years; Peak V · O₂∶ 59 ± 8 mL·kg^-1·min^-1) completed three 1 h cycling time-trials (30 °C, 50% RH) with either NFI, TDFI or PFI designed to maintain body mass (BM) at ~0.5% of pre-exercise BM. Body mass loss reached 2.9 ± 0.4, 2.2 ± 0.3 and 0.6 ± 0.2% with NFI, TDFI and PFI, respectively. Heart rate, rectal and mean skin temperatures and ratings of perceived exertion and of abdominal discomfort diverged marginally among trials. Mean distance completed (NFI: 35.6 ± 1.9 km; TDFI: 35.8 ± 2.0; PFI: 35.7 ± 2.0) and, hence, average power output maintained during the time-trials did not significantly differ among trials, and the impact of both PFI and TDFI vs. NFI was deemed trivial or unclear. These findings indicate that neither PFI nor TDFI are likely to offer any advantage over NFI during a 1 h cycling time-trial.

Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance-Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review

Exercise-associated hyponatremia (EAH) is defined as a plasma sodium concentration of <135 mmol/L during or after endurance and ultra-endurance performance and was first described by Timothy Noakes when observed in ultra-marathoners competing in the Comrades Marathon in South Africa in the mid-1980s. It is well-established that a decrease in plasma sodium concentration <135 mmol/L occurs with excessive fluid intake. Clinically, a mild hyponatremia will lead to no or very unspecific symptoms. A pronounced hyponatremia (<120 mmol/L) will lead to central nervous symptoms due to cerebral edema, and respiratory failure can lead to death when plasma sodium concentration reaches values of <110-115 mmol/L. The objective of this narrative review is to present new findings about the aspects of sex, race location, sports discipline, and length of performance. The prevalence of EAH depends on the duration of an endurance performance (i.e., low in marathon running, high to very high in ultra-marathon running), the sports discipline (i.e., rather rare in cycling, more frequent in running and triathlon, and very frequent in swimming), sex (i.e., increased in women with several reported deaths), the ambient temperature (i.e., very high in hot temperatures) and the country where competition takes place (i.e., very common in the USA, very little in Europe, practically never in Africa, Asia, and Oceania). A possible explanation for the increased prevalence of EAH in women could be the so-called Varon-Ayus syndrome with severe hyponatremia, lung and cerebral edema, which was first observed in marathon runners. Regarding the race location, races in Europe seemed to be held under rather moderate conditions whereas races held in the USA were often performed under thermally stressing conditions (i.e., greater heat or greater cold).

[Exercise-Associated Hyponatremia in Endurance Performance]

Exercise-Associated Hyponatremia in Endurance Performance Abstract. Exercise-associated hyponatremia is defined as a plasma sodium concentration of <135 mmol/l and was first described by Timothy Noakes at the Comrades Marathon in South Africa in the mid-1980s. A decrease in plasma sodium <135 mmol/l occurs with excessive fluid intake. Risk factors include long to very long endurance performance, extreme climatic conditions, female gender and competitions in the USA. Regarding its prevalence by sport, exercise-associated hyponatraemia tends to occur while swimming and running, but rarely when cycling. While mild exercise-associated hyponatremia does not lead to clinical symptoms, severe hyponatremia due to cerebral edema can lead to neurological deficits and even death. The best prevention of exercise-associated hyponatremia is the reduction of fluid intake during exercise.

The ergogenic potency of carbohydrate mouth rinse on endurance running performance of dehydrated athletes

PURPOSE

To examine the effect of carbohydrate (CHO) mouth rinsing on endurance running responses and performance in dehydrated individuals.

METHODS

In a double blind, randomised crossover design, 12 well-trained male runners completed 4 running time to exhaustion (TTE) trials at a speed equivalent to 70% of VO_2peak in a thermoneutral condition. Throughout each run, participants mouth rinsed and expectorated every 15 min either 25 mL of 6% CHO or a placebo (PLA) solution for 10 s. The four TTEs consisted of two trials in the euhydrated (EU-CHO and EU-PLA) and two trials in the dehydrated (DY-CHO and DY-PLA) state. Prior to each TTE run, participants were dehydrated via exercise and allowed a passive rest period during which they were fed and either rehydrated equivalent to their body mass deficit (i.e., EU trials) or ingested only 50 mL of water (DY trials).

RESULTS

CHO mouth rinsing significantly improved TTE performance in the DY compared to the EU trials (78.2 ± 4.3 vs. 76.9 ± 3.8 min, P = 0.02). The arousal level of the runners was significantly higher in the DY compared to the EU trials (P = 0.02). There was no significant difference among trials in heart rate, plasma glucose and lactate, and psychological measures.

CONCLUSIONS

CHO mouth rinsing enhanced running performance significantly more when participants were dehydrated vs. euhydrated due to the greater sensitivity of oral receptors related to thirst and central mediated activation. These results show that level of dehydration alters the effect of brain perception with presence of CHO.

Changes in Pain and Nutritional Intake Modulate Ultra-Running Performance: A Case Report

Ultra-endurance running provides numerous physiological, psychological, and nutritional challenges to the athlete and supporting practitioners. We describe the changes in physiological status, psychological condition, and nutritional intake over the course of two 100-mile running races, with differing outcomes: non-completion and completion. Athlete perception of pain, freshness, and motivation differed between events, independent of rating of perceived exertion. Our data suggest that the integration of multiple sensations (freshness, motivation, hunger, pain, and thirst) produce performance. Increases in carbohydrate feeding (+5 g·h⁻¹) and protein intake (+0.3 g·kg⁻¹) also likely contributed to successful completion of a 100-mile race, by reducing the fractional utilization of maximal oxygen uptake and satiating hunger, respectively. Nutritional data support the notion that the gut is a trainable, and critical organ with respect to ultra-endurance performance. Finally, we propose future research to investigate the rate at which peak feeding occurs throughout ultra-endurance events, as this may further serve to personalize sports nutrition strategies.

Intended Hydration Strategies and Knowledge of Exercise-Associated Hyponatraemia in Marathon Runners: A Questionnaire-Based Study

CONTEXT

  Exercise-associated hyponatremia (EAH) is a potentially fatal condition that can be prevented by avoiding excessive fluid intake. Running has become more popular in recent years, so it is important to assess the safety of runners' hydration strategies.

OBJECTIVE

  (1) To explore the intended hydration strategies of a sample of marathon runners before the 2014 London Marathon, (2) to examine their sources of information and knowledge about fluid intake and their understanding of EAH, and (3) to compare these findings with the results of a similar study carried out before the 2010 London Marathon.

DESIGN

  Cross-sectional study.

SETTING

  The 2014 London Marathon.

PATIENTS OR OTHER PARTICIPANTS

  A total of 298 runners (148 males, 150 females), 0.83% of all race finishers.

MAIN OUTCOME MEASURE(S)

  Planned frequency, type, and volume of hydration; sources of information about appropriate drinking; and understanding of hyponatremia were explored. Comparisons were made with data collected from a sample of participants at the 2010 London Marathon. Data relating to the 2014 cohort are presented in descriptive form. Comparisons of the 2010 and 2014 cohorts were conducted using parametric and nonparametric methods.

RESULTS

  A total of 48.7% of the 2014 cohort listed drinking to thirst as the most important factor affecting their hydration strategy during the race. This compared with 25.3% of runners from the 2010 cohort and represented an increase (χ² = 29.1, P = .001); 5.8% of the 2014 cohort planned on drinking more than 3.5 L, compared with 12% of the 2010 cohort (χ² = 4.310, P = .038).

CONCLUSIONS

  The number of sampled individuals using thirst to guide hydration strategies in the 2014 London Marathon increased from 2010. However, more than half of the 2014 cohort was not planning to drink to thirst. Runners still need to be educated about the risks of overdrinking as they continue to demonstrate a lack of knowledge and understanding.

Progressive Dehydration in Junior Laser Class Sailors During World Championship

The purpose of this article is to assess the hydration status of elite young sailing athletes during World Championship competition. Twelve young, elite, male, Laser Class sailors (age: 15.8 ± 1.1 y, height: 1.74 ± 0.1 m, weight: 65.1 ± 1.5 kg, body fat: 12.5 ± 3.1%, training experience: 7.0 ± 1.2 y) participated in this descriptive study. After three-day baseline bodyweight measurements, hydration status was assessed via pre- and post-race body weights, urine-specific gravity, and thirst ratings via a visual analog scale during four consecutive days of racing. Measurements and data collection took place at the same time each racing day, with mean environmental temperature, humidity, and wind speed at 23.0 ± 0.8°C, 64-70%, and 9 ± 1 knots, respectively. Average racing time was 130 ± 9 min. Body weight was significantly decreased following each race-day as compared to prerace values (Day 1: -1.1 ± 0.2, Day 2: -2.5 ± 0.1, Day 3: -2.8 ± 0.1, and Day 4: -3.0 ± 0.1% of body weight; p < 0.05). The participants exhibited dehydration of -2.9 ± 0.2 and -5.8 ± 0.2% of body weight before and after the fourth racing day as compared to the three-day baseline body weight. Urine-specific gravity (pre-post → Day 1: 1.014-1.017; Day 2: 1.019-1.024; Day 3: 1.021-1.026; Day 4: 1.022-1.027) and thirst (pre-post → Day 1: 2.0-5.2; Day 2: 3.2-5.5; Day 3: 3.7-5.7; Day 4: 3.8-6.8) were also progressively and significantly elevated throughout the four days of competition. The data revealed progressive dehydration throughout four consecutive days of racing as indicated by decreased body weight, elevated urine concentration, and high thirst.

Engineering Approaches to Assessing Hydration Status

Dehydration is a common condition characterized by a decrease in total body water. Acute dehydration can cause physical and cognitive impairment, heat stroke and exhaustion, and, if severe and uncorrected, even death. The health effects of chronic mild dehydration are less well studied with urolithiasis (kidney stones) the only condition consistently associated with it. Aside from infants and those with particular medical conditions, athletes, military personnel, manual workers, and older adults are at particular risk of dehydration due to their physical activity, environmental exposure, and/or challenges in maintaining fluid homeostasis. This review describes the different approaches that have been explored for hydration assessment in adults. These include clinical indicators perceived by the patient or detected by a practitioner and routine laboratory analyses of blood and urine. These techniques have variable accuracy and practicality outside of controlled environments, creating a need for simple, portable, and rapid hydration monitoring devices. We review the wide array of devices proposed for hydration assessment based on optical, electromagnetic, chemical, and acoustical properties of tissue and bodily fluids. However, none of these approaches has yet emerged as a reliable indicator in diverse populations across various settings, motivating efforts to develop new methods of hydration assessment.

The Influence of Mid-Event Deception on Psychophysiological Status and Pacing Can Persist across Consecutive Disciplines and Enhance Self-paced Multi-modal Endurance Performance

Purpose: To examine the effects of deceptively aggressive bike pacing on performance, pacing, and associated physiological and perceptual responses during simulated sprint-distance triathlon.

Methods: Ten non-elite, competitive male triathletes completed three simulated sprint-distance triathlons (0.75 km swim, 500 kJ bike, 5 km run), the first of which established personal best “baseline” performance (BL). During the remaining two trials athletes maintained a cycling power output 5% greater than BL, before completing the run as quickly as possible. However, participants were informed of this aggressive cycling strategy before and during only one of the two trials (HON). Prior to the alternate trial (DEC), participants were misinformed that cycling power output would equal that of BL, with on-screen feedback manipulated to reinforce this deception.

Results: Compared to BL, a significantly faster run performance was observed following DEC cycling (p < 0.05) but not following HON cycling (1348 ± 140 vs. 1333 ± 129 s and 1350 ± 135 s, for BL, DEC, and HON, respectively). As such, magnitude-based inferences suggest HON running was more likely to be slower, than faster, compared to BL, and that DEC running was probably faster than both BL and HON. Despite a trend for overall triathlon performance to be quicker during DEC (4339 ± 395 s) compared to HON (4356 ± 384 s), the only significant and almost certainly meaningful differences were between each of these trials and BL (4465 ± 420 s; p < 0.05). Generally, physiological and perceptual strain increased with higher cycling intensities, with little, if any, substantial difference in physiological and perceptual response during each triathlon run.

Conclusions: The present study is the first to show that mid-event pace deception can have a practically meaningful effect on multi-modal endurance performance, though the relative importance of different psychophysiological and emotional responses remains unclear. Whilst our findings support the view that some form of anticipatory “template” may be used by athletes to interpret levels of psychophysiological and emotional strain, and regulate exercise intensity accordingly, they would also suggest that individual constructs such as RPE and affect may be more loosely tied with pacing than previously suggested.

Heat stress and dehydration in adapting for performance: Good, bad, both, or neither?

Physiological systems respond acutely to stress to minimize homeostatic disturbance, and typically adapt to chronic stress to enhance tolerance to that or a related stressor. It is legitimate to ask whether dehydration is a valuable stressor in stimulating adaptation per se. While hypoxia has had long-standing interest by athletes and researchers as an ergogenic aid, heat and nutritional stressors have had little interest until the past decade. Heat and dehydration are highly interlinked in their causation and the physiological strain they induce, so their individual roles in adaptation are difficult to delineate. The effectiveness of heat acclimation as an ergogenic aid remains unclear for team sport and endurance athletes despite several recent studies on this topic. Very few studies have examined the potential ergogenic (or ergolytic) adaptations to ecologically-valid dehydration as a stressor in its own right, despite longstanding evidence of relevant fluid-regulatory adaptations from short-term hypohydration. Transient and self-limiting dehydration (e.g., as constrained by thirst), as with most forms of stress, might have a time and a place in physiological or behavioral adaptations independently or by exacerbating other stressors (esp. heat); it cannot be dismissed without the appropriate evidence. The present review did not identify such evidence. Future research should identify how the magnitude and timing of dehydration might augment or interfere with the adaptive processes in behaviorally constrained versus unconstrained humans.

Fluid Balance During Training in Elite Young Athletes of Different Sports

Although there are many studies demonstrating a high percentage of adult athletes who start exercise in suboptimal hydration state, limited data concerning hydration levels in athletic youth exist. The purpose of this study was to identify the hydration status of elite young athletes of different sports, during a typical day of training. Fifty-nine young elite male athletes from different sports (basketball, gymnastics, swimming, running, and canoeing) participated in the study (age: 15.2 ± 1.3 years; years of training: 7.7 ± 2.0). Hydration status was assessed in the morning, before and immediately after practice. Data collection took place at the same time of the day, with mean environmental temperature and humidity at the time of the measurements at 27.6 ± 0.9° C and 58 ± 8%, respectively. All athletes trained for approximately 90 minutes, and they were consuming fluids ad libitum throughout their practice. Over 89% of the athletes were hypohydrated (urine specific gravity [USG] ≥1.020 mg·dl) based on their first morning urine sample. Pretraining urine samples revealed that 76.3% of the athletes were hypohydrated, whereas a significant high percent remained hypohydrated even after training according to USG values ≥1.020 mg·dl (74.5%) and urine color scale: 5-6 (76.3%). Mean body weight loss during training was -1.1 ± 0.07%. We concluded that the prevalence of hypohydration among elite young athletes is very high, as indicated by the USG and urine color values. The majority of the athletes was hypohydrated throughout the day and dehydrated even more during practice despite fluid availability.

Ad-libitum drinking and performance during a 40-km cycling time trial in the heat

The aim of this study was to investigate if drinking ad-libitum can counteract potential negative effects of a hypohydrated start caused by fluid restriction during a 40-km time trial (TT) in the heat. Twelve trained males performed one 40-km cycling TT euhydrated (EU: no water during the TT) and two 40-km cycling TTs hypohydrated. During one hypohydrated trial no fluid was ingested (HYPO), during the other trial ad-libitum water ingestion was allowed (FLUID). Ambient temperature was 35.2 ± 0.2 °C, relative humidity 51 ± 3% and airflow 7 m·s(-1). Body mass (BM) was determined at the start of the test, and before and after the TT. During the TT, power output, heart rate (HR), gastrointestinal temperature, mean skin temperature, rating of perceived exertion (RPE), thermal sensation, thermal comfort and thirst sensation were measured. Prior to the start of the TT, BM was 1.2% lower in HYPO and FLUID compared to EU. During the TT, BM loss in FLUID was lower compared to EU and HYPO (1.0 ± 0.8%, 2.7 ± 0.2% and 2.6 ± 0.3%, respectively). Hydration status had no effect on power output (EU: 223 ± 32 W, HYPO: 217 ± 39 W, FLUID: 224 ± 35 W), HR, gastrointestinal temperature, mean skin temperature, RPE, thermal sensation and thermal comfort. Thirst sensation was higher in HYPO than in EU and FLUID. It was concluded that hypohydration did not adversely affect performance during a 40-km cycling TT in the heat. Therefore, whether or not participants consumed fluid during exercise did not influence their TT performance.

Opportunities for intervention strategies for weight management: global actions on fluid intake patterns

Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.

Are we being drowned in hydration advice? Thirsty for more?

Hydration pertains simplistically to body water volume. Functionally, however, hydration is one aspect of fluid regulation that is far more complex, as it involves the homeostatic regulation of total body fluid volume, composition and distribution. Deliberate or pathological alteration of these regulated factors can be disabling or fatal, whereas they are impacted by exercise and by all environmental stressors (e.g. heat, immersion, gravity) both acutely and chronically. For example, dehydration during exercising and environmental heat stress reduces water volume more than electrolyte content, causing hyperosmotic hypohydration. If exercise continues for many hours with access to food and water, composition returns to normal but extracellular volume increases well above baseline (if exercising upright and at low altitude). Repeating bouts of exercise or heat stress does likewise. Dehydration due to physical activity or environmental heat is a routine fluid-regulatory stress. How to gauge such dehydration and - more importantly-what to do about it, are contested heavily within sports medicine and nutrition. Drinking to limit changes in body mass is commonly advocated (to maintain ≤2% reduction), rather than relying on behavioural cues (mainly thirst) because the latter has been deemed too insensitive. This review, as part of the series on moving in extreme environments, critiques the validity, problems and merits of externally versus autonomously controlled fluid-regulatory behaviours, both acutely and chronically. Our contention is that externally advocated hydration policies (especially based on change in body mass with exercise in healthy individuals) have limited merit and are extrapolated and imposed too widely upon society, at the expense of autonomy. More research is warranted to examine whether ad libitum versus avid drinking is beneficial, detrimental or neither in: acute settings; adapting for obligatory dehydration (e.g. elite endurance competition in the heat), and; development of chronic diseases that are associated with an extreme lack of environmental stress.

Relationship between physiological parameters and performance during a half-ironman triathlon in the heat

Triathlon is a popular outdoor endurance sport performed under a variety of environmental conditions. The aim of this study was to assess physiological variables before and after a half-ironman triathlon in the heat and to analyse their relationship with performance. Thirty-four well-trained triathletes completed a half-ironman triathlon in a mean dry temperature of 29 ± 3ºC. Before and within 1 min after the end of the race, body mass, core temperature, maximal jump height and venous blood samples were obtained. Mean race time was 315 ± 40 min, with swimming (11 ± 1%), cycling (49 ± 2%) and running (40 ± 3%) representing different amounts of the total race time. At the end of the competition, body mass changed by -3.8 ± 1.6% and the change in body mass correlated positively with race time (r = 0.64; P < 0.001). Core temperature increased from 37.5 ± 0.6ºC to 38.8 ± 0.7ºC (P < 0.001) and post-race core temperature correlated negatively with race time (r = -0.47; P = 0.007). Race time correlated positively with the decrease in jump height (r = 0.38; P = 0.043), post-race serum creatine kinase (r = 0.55; P = 0.001) and myoglobin concentrations (r = 0.39; P = 0.022). In a half-ironman triathlon in the heat, greater reductions in body mass and higher post-competition core temperatures were present in faster triathletes. In contrast, slower triathletes presented higher levels of muscle damage and decreased muscle performance.

Fluid intake and all-cause mortality, cardiovascular mortality and kidney function: a population-based longitudinal cohort study

BACKGROUND

Drinking eight glasses of fluid or water each day is widely believed to improve health, but evidence is sparse and conflicting. We aimed to investigate the association between fluid consumption and long-term mortality and kidney function.

METHODS

We conducted a longitudinal analysis within a prospective, population-based cohort study of 3858 men and women aged 49 years or older residing in Australia. Daily fluid intake from food and beverages not including water was measured using a food frequency questionnaire. We did multivariable adjusted Cox proportional hazard models for all-cause and cardiovascular mortality and a boot-strapping procedure for estimated glomerular filtration rate (eGFR).

RESULTS

Upper and lower quartiles of daily fluid intake corresponded to >3 L and <2 L, respectively. During a median follow-up of 13.1 years (total 43 093 years at risk), 1127 deaths (26.1 per 1000 years at risk) including 580 cardiovascular deaths (13.5 per 1000 years at risk) occurred. Daily fluid intake (per 250 mL increase) was not associated with all-cause [adjusted hazard ratio (HR) 0.99 (95% CI 0.98-1.01)] or cardiovascular mortality [HR 0.98 (95% CI 0.95-1.01)]. Overall, eGFR reduced by 2.2 mL/min per 1.73 m(2) (SD 10.9) in the 1207 (31%) participants who had repeat creatinine measurements and this was not associated with fluid intake [adjusted regression coefficient 0.06 mL/min/1.73 m(2) per 250 mL increase (95% CI -0.03 to 0.14)].

CONCLUSIONS

Fluid intake from food and beverages excluding water is not associated with improved kidney function or reduced mortality.

The effect of prescribed fluid consumption on physiology and work behavior of wildfire fighters

The purpose of this study was to examine 1) wildfire fighters' ability to consume the prescribed fluid volume (1200 mL h(-1)), 2) the effect of fluid intake on plasma sodium and hydration, and 3) the effect of fluid intake on firefighters' heart rate, core temperature and activity during emergency suppression shifts.

METHODS

Thirty-four firefighters were divided into ad libitum (AD, n = 17) and prescribed (PR, n = 17) drinking groups.

RESULTS

PR drinkers did not meet the prescribed fluid target, yet consumed over double the volume of AD drinkers. No differences between groups in plasma sodium or hydration were noted. PR drinking resulted in lower core temperature between 2 and 6 h. This did not coincide with reduced cardiovascular strain, greater work activity or larger distances covered when compared to AD drinkers.

CONCLUSION

Extra fluid consumption (above AD) did not improve firefighter activity or physiological function (though PR firefighters core temperature was lower earlier in their shift). Firefighter can self-regulate their fluid consumption behavior and work rate to leave the fireground euhydrated.

Ice slurry ingestion during cycling improves Olympic distance triathlon performance in the heat

This study investigated the effect of ice slurry ingestion during a triathlon on intragastric temperature and 10 km running performance in the heat. Nine well-trained male triathletes performed two randomised trials of a simulated Olympic distance triathlon in hot conditions (32-34°C). Exercise intensity during the swim (1500 m) and cycle (1 hr) legs was standardised, and the 10 km run leg was a self-paced time trial. During the cycle leg, either 10 g · kgBM(-1) of ice slurry (< 1°C) or room temperature fluid (32-34°C) was ingested. In the run leg of the ice slurry trial, performance time (43.4 ± 3.7 vs. 44.6 ± 4.0 min; P = 0.03), intragastric temperature (at 1.5 km; 35.5 ± 1.2 vs. 37.5 ± 0.4°C; P = 0.002) and perceived thermal stress (at 5 km; 73 ± 9 vs. 80 ± 7 mm; P = 0.04) were significantly lower. Oxygen consumption was significantly higher in the ice trial between 9.5-10 km (52.4 ± 3.4 vs. 47.8 ± 5.4 mL · kg(-1) · min(-1); P = 0.04). The results suggest ice slurry ingestion was an effective ergogenic aid for triathlon running performance in the heat. The attenuation of intragastric temperature and perceived thermal stress were likely contributors to the self-selection of a higher running intensity and improved performance time.