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Brown GA, Shaw BS, Shaw I. How much water is in a mouthful, and how many mouthfuls should I drink? A laboratory exercise to help students understand developing a hydration plan. ADVANCES IN PHYSIOLOGY EDUCATION 2021; 45:589-593. [PMID: 34379481 DOI: 10.1152/advan.00062.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
Preventing impairments in athletic performance is an important concept for students that are preparing for careers that involve working with athletes. Gaining hands on, laboratory-based experience in measuring exercise induced dehydration can help students understand how to help athletes prevent dehydration induced impairment in performance. This article describes a laboratory exercise for junior and senior students in a sports nutrition class, in which the students measure changes in body mass (as a measure of dehydration) due to 40 min of moderate-intensity exercise and 40 min of vigorous-intensity exercise. The students also measure how much water is in a mouthful from a sports bottle and from a drinking fountain. The students then calculate how many mouthfuls are necessary to replace exercise induced fluid losses. This laboratory exercise has been well received by students and has improved performance on the test regarding hydration.
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Affiliation(s)
- Gregory A Brown
- Physical Activity and Wellness Laboratory, Department of Kinesiology and Sports Science, University of Nebraska, Kearney, Nebraska
| | - Brandon S Shaw
- Department of Human Movement Science, University of Zululand, Kwadlangezwa, South Africa
| | - Ina Shaw
- Department of Human Movement Science, University of Zululand, Kwadlangezwa, South Africa
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Rosinger AY, Chang AM, Buxton OM, Li J, Wu S, Gao X. Short sleep duration is associated with inadequate hydration: cross-cultural evidence from US and Chinese adults. Sleep 2020; 42:5155420. [PMID: 30395316 DOI: 10.1093/sleep/zsy210] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Indexed: 01/11/2023] Open
Abstract
Study Objectives Short and long sleep durations are linked to reduced kidney function, but little research has examined how sleep is associated with hydration status. Our aim was to assess the relationship between sleep duration and urinary hydration biomarkers among adults in a cross-cultural context. Methods Three samples of adults aged ≥20 years were analyzed: 2007-2008 National Health and Nutrition Examination Survey (NHANES; n = 4680), 2009-2012 NHANES (n = 9559), and 2012 cross-sectional wave of the Chinese Kailuan Study (n = 11903), excluding pregnant women and adults with failing kidneys. We estimated multiple linear regression models between self-reported usual night-time sleep duration (<6, 6, 7, 8 (reference), and ≥9 hr/day) and urine specific gravity (Usg) and urine osmolality (Uosm) as continuous variables and logistic regression models dichotomized as inadequate hydration (>1.020 g/mL; >831 mOsm/kg). In primary analyses, we estimated models excluding diabetes and diuretic medications for healthier subpopulations (NHANES, n = 11353; Kailuan, n = 8766). Results In the healthier NHANES subset, 6 hr was associated with significantly higher Usg and odds of inadequate hydration (adjusted OR: 1.59, 95% CI: 1.25, 2.03) compared with 8 hr. Regression results were mixed using Uosm, but in the same direction as Usg. Among Chinese adults, short sleep duration (<6 and 6 hr) was associated with Usg and higher likelihood of inadequate hydration (6 hr adjusted OR: 1.42, 95% CI: 1.26, 1.60). No consistent association was found with sleeping ≥9 hr. Conclusions Short sleep duration was associated with higher odds of inadequate hydration in US and Chinese adults relative to sleeping 8 hr.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Department of Anthropology, Pennsylvania State University, State College, PA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Division of Sleep Medicine, Harvard Medical School, Harvard University, Cambridge, MA
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutrition, Pennsylvania State University, State College, PA
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Wutich A, Rosinger AY, Stoler J, Jepson W, Brewis A. Measuring Human Water Needs. Am J Hum Biol 2019; 32:e23350. [PMID: 31702101 PMCID: PMC7050503 DOI: 10.1002/ajhb.23350] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/02/2019] [Accepted: 10/11/2019] [Indexed: 12/11/2022] Open
Abstract
Water connects the environment, culture, and biology, yet only recently has it emerged as a major focus for research in human biology. To facilitate such research, we describe methods to measure biological, environmental, and perceptual indicators of human water needs. This toolkit provides an overview of methods for assessing different dimensions of human water need, both well‐established and newly‐developed. These include: (a) markers of hydration (eg, urine specific gravity, doubly labeled water) important for measuring the impacts of water need on human biological functioning; (b) methods for measuring water quality (eg, digital colorimeter, membrane filtration) essential for understanding the health risks associated with exposure to microbiological, organic, metal, inorganic nonmental, and other contaminants; and (c) assessments of household water insecurity status that track aspects of unmet water needs (eg, inadequate water service, unaffordability, and experiences of water insecurity) that are directly relevant to human health and biology. Together, these methods can advance new research about the role of water in human biology and health, including the ways that insufficient, unsafe, or insecure water produces negative biological and health outcomes.
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Affiliation(s)
| | - Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania.,Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
| | - Justin Stoler
- Department of Geography, University of Miami, Coral Gables, Florida.,Department of Public Health Sciences, University of Miami, Miami, Florida
| | - Wendy Jepson
- Department of Geography, Texas A&M University, College Station, Texas
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Abstract
OBJECTIVE To assess the diagnostic ability of urine reagent strips to identify hypohydration based on urine specific gravity (USG). DESIGN This study examined the agreement of USG between strips and refractometry with Bland-Altman, whereas the diagnostic ability of the strips to assess hypohydration was performed by receiver operating characteristic analysis. SETTING Arkansas high school football preseason practice. PARTICIPANTS Four hundred fourteen fresh urine samples were analyzed. MAIN OUTCOME MEASURES Urine specific gravity was assessed by both reagent strips and refractometry. Cutoffs of >1.020 and >1.025 were used for identifying hypohydration. RESULTS Bland-Altman analysis showed agreement of the 2 methods. Overall diagnostic ability of the urine strip to identify hypohydration was fair (area under the curve 72%-78%). However, the sensitivity to correctly identify hypohydration was poor (63%-71%), and the specificity of correctly identifying euhydration was poor to fair (68%-83%). CONCLUSION The urine strip method is not valid for assessing hypohydration.
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Zubac D, Reale R, Karnincic H, Sivric A, Jelaska I. Urine specific gravity as an indicator of dehydration in Olympic combat sport athletes; considerations for research and practice. Eur J Sport Sci 2018; 18:920-929. [PMID: 29746803 DOI: 10.1080/17461391.2018.1468483] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Urine specific gravity (USG) is the most commonly reported biochemical marker used in research and applied settings to detect fluid deficits in athletes, including those participating in combat sports. Despite the popularity of its use, there has been a growing debate regarding the diagnostic accuracy and the applicability of USG in characterizing whole-body fluid status and fluctuations. Moreover, recent investigations report universally high prevalence of hypohydration (∼90%) via USG assessment in combat sport athletes, often in spite of stable body-mass. Given the widespread use in both research and practice, and its use in a regulatory sense as a 'hydration test' in combat sports as a means to detect dehydration at the time of weigh-in; understanding the limitations and applicability of USG assessment is of paramount importance. Inconsistencies in findings of USG readings, possibly as a consequence of diverse methodological research approaches and/or overlooked confounding factors, preclude a conclusive position stand within current combat sports research and practice. Thus the primary aim of this paper is to critically review the literature regarding USG assessment of hydration status in combat sports research and practice. When taken on balance, the existing literature suggests: the use of laboratory derived benchmarks in applied settings, inconsistent sampling methodologies, the incomplete picture of how various confounding factors affect end-point readings, and the still poorly understood potential of renal adaptation to dehydration in combat athletes; make the utility of hydration assessment via USG measurement quite problematic, particularly when diet and training is not controlled.
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Affiliation(s)
- Damir Zubac
- a Science and Research Center Koper , Institute for Kinesiology Research , Koper , Slovenia.,c Faculty of Kinesiology , University of Split , Split , Croatia
| | - Reid Reale
- b Gatorade Sports Science Institute , Bradenton , FL , USA
| | - Hrvoje Karnincic
- c Faculty of Kinesiology , University of Split , Split , Croatia
| | | | - Igor Jelaska
- c Faculty of Kinesiology , University of Split , Split , Croatia
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McDermott BP, Anderson SA, Armstrong LE, Casa DJ, Cheuvront SN, Cooper L, Kenney WL, O'Connor FG, Roberts WO. National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train 2017; 52:877-895. [PMID: 28985128 PMCID: PMC5634236 DOI: 10.4085/1062-6050-52.9.02] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
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.
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Zubac D, Marusic U, Karninčič H. Hydration Status Assessment Techniques and Their Applicability Among Olympic Combat Sports Athletes: Literature Review. Strength Cond J 2016. [DOI: 10.1519/ssc.0000000000000236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wyness SP, Hunsaker JJ, Snow TM, Genzen JR. Evaluation and analytical validation of a handheld digital refractometer for urine specific gravity measurement. Pract Lab Med 2016; 5:65-74. [PMID: 28856206 PMCID: PMC5574504 DOI: 10.1016/j.plabm.2016.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/13/2016] [Accepted: 06/01/2016] [Indexed: 11/28/2022] Open
Abstract
Objectives Refractometers are commonly used to determine urine specific gravity (SG) in the assessment of hydration status and urine specimen validity testing. Few comprehensive performance evaluations are available demonstrating refractometer capability from a clinical laboratory perspective. The objective of this study was therefore to conduct an analytical validation of a handheld digital refractometer used for human urine SG testing. Design and methods A MISCO Palm Abbe™ refractometer was used for all experiments, including device familiarization, carryover, precision, accuracy, linearity, analytical sensitivity, evaluation of potential substances which contribute to SG (i.e. “interference”), and reference interval evaluation. A manual refractometer, urine osmometer, and a solute score (sum of urine chloride, creatinine, glucose, potassium, sodium, total protein, and urea nitrogen; all in mg/dL) were used as comparative methods for accuracy assessment. Results Significant carryover was not observed. A wash step was still included as good laboratory practice. Low imprecision (%CV, <0.01) was demonstrated using low and high QC material. Accuracy studies showed strong correlation to manual refractometry. Linear correlation was also demonstrated between SG, osmolality, and solute score. Linearity of Palm Abbe performance was verified with observed error of ≤0.1%. Increases in SG were observed with increasing concentrations of albumin, creatinine, glucose, hemoglobin, sodium chloride, and urea. Transference of a previously published urine SG reference interval of 1.0020–1.0300 was validated. Conclusions The Palm Abbe digital refractometer was a fast, simple, and accurate way to measure urine SG. Analytical validity was confirmed by the present experiments.
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Key Words
- ACSM, American College of Sports Medicine
- ALB, albumin
- AMR, analytical measurement range
- ARUP, Associated Regional & University Pathologists
- CLSI, Clinical & Laboratory Standards Institute
- CR, creatinine
- CV, coefficient of variation
- Cl, chloride
- Digital refractometry
- FDA, Food and Drug Administration
- GLU, glucose
- Hydration
- IRB, Institutional Review Board
- K+, potassium
- LIMS, laboratory information management system
- LLMI, lower limit of the measuring interval
- LOB, limit of blank
- LOD, limit of detection
- LOQ, limit of quantitation
- NATA, National Athletic Trainers Association
- NCAA, National Collegiate Athletic Association
- Na, sodium
- Osmolality
- POC, point of care
- QC, quality control
- RI, reference interval
- SAMHSA, Substance Abuse and Mental Health Services Administration
- SD, standard deviation
- SG, specific gravity
- Specific gravity
- Sports medicine
- TAE, total allowable error
- TE, total error
- TP, total protein
- UN, urea nitrogen
- Urine adulteration
- Urine drug testing
- ddH2O, demineralized distilled water
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Affiliation(s)
- Sara P. Wyness
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Joshua J.H. Hunsaker
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Taylor M. Snow
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Jonathan R. Genzen
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
- Department of Pathology, University of Utah, 500 Chipeta Way, Mail Code 115, Salt Lake City, UT 84108, United States
- Corresponding author at: Department of Pathology, University of Utah, 500 Chipeta Way, Mail Code 115, Salt Lake City, UT 84108, United States.Department of Pathology, University of Utah500 Chipeta Way, Mail Code 115Salt Lake CityUT84108United States
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