Fluid replacement and exercise stress. A brief review of studies on fluid replacement and some guidelines for the athlete

Effects of Sodium Intake on Health and Performance in Endurance and Ultra-Endurance Sports

The majority of reviews on sports nutrition issues focus on macronutrients, often omitting or paying less attention to substances such as sodium. Through the literature, it is clear that there are no reviews that focus entirely on the effects of sodium and in particular on endurance sports. Sodium intake, both at high and low doses, has been found to be associated with health and performance issues in athletes. Besides, there have been theories that an electrolyte imbalance, specifically sodium, contributes to the development of muscle cramps (EAMC) and hyponatremia (EAH). For this reason, it is necessary to create this systematic review, in order to report extensively on the role of sodium consumption in the population and more specifically in endurance and ultra-endurance athletes, the relationship between the amount consumed and the occurrence of pathological disorders, the usefulness of simultaneous hydration and whether a disturbance of this substance leads to EAH and EAMC. As a method of data collection, this study focused on exploring literature from 2000–2021. The search was conducted through the research engines PubMed and Scopus. In order to reduce the health and performance effects in endurance athletes, simultaneous emphasis should be placed on both sodium and fluid intake.

A double-blinded randomized controlled trial on the effects of increased intravenous hydration in nulliparas undergoing induction of labor

BACKGROUND

Rates of labor induction are increasing, raising concerns related to increased healthcare utilization costs. High-dose intravenous fluid (250 cc/h) has been previously demonstrated to shorten the time to delivery in nulliparous individuals in spontaneous labor. Whether or not this relationship exists among individuals undergoing induction of labor is unknown.

OBJECTIVE

Our study aimed to evaluate the effect of high-dose intravenous hydration on time to delivery among nulliparous individuals undergoing induction of labor.

STUDY DESIGN

Nulliparous individuals presenting for induction of labor with a Bishop score of ≤6 (with and without rupture of membranes) were randomized to receive either 125 cc/h or 250 cc/h of normal saline. The primary outcome was length of labor (defined as time from initiation of study fluids to delivery). Both time to overall delivery and vaginal delivery were evaluated. Secondary outcomes included the lengths of each stage of labor, the percentage of individuals delivering within 24 hours, and maternal and neonatal outcomes, including cesarean delivery rate.

RESULTS

A total of 180 individuals meeting inclusion criteria were enrolled and randomized. Baseline demographic characteristics were similar between groups; however, there was a higher incidence of diabetes mellitus in the group receiving 125 cc/h. Average length of labor was similar between groups (27.6 hours in 250 cc/h and 27.8 hours in 125 cc/h), as was the length of each stage of labor. Cox regression analysis did not demonstrate an effect of fluid rate on time to delivery. Neither the admission Bishop score, body mass index, nor other demographic characteristics affected time to delivery or vaginal delivery. There were no differences in maternal or neonatal outcomes, including overall cesarean delivery rate, clinically apparent iatrogenic intraamniotic infection, Apgar scores, need for neonatal phototherapy, or neonatal intensive care unit stay.

CONCLUSION

There were no observed differences in the length of labor or maternal or neonatal outcomes with the administration of an increased rate of intravenous fluids among nulliparous individuals undergoing induction of labor.

Hydration Is More Important Than Exogenous Carbohydrate Intake During Push-to-the-Finish Cycle Exercise in the Heat

Dehydration ≥2% loss of body mass is associated with reductions in performance capacity, and carbohydrate (CHO)-electrolyte solutions (CES) are often recommended to prevent dehydration and provide a source of exogenous carbohydrate during exercise. It is also well established that performance capacity in the heat is diminished compared to cooler conditions, a response attributable to greater cardiovascular strain caused by high skin and core temperatures. Because hydration status, environmental conditions, and carbohydrate availability interact to influence performance capacity, we sought to determine how these factors affect push-to-the-finish cycling performance. Ten young trained cyclists exercised at a moderate intensity (2.5 W·kg^-1) in a hot-dry condition [40°C, 20% relative humidity (RH)] until dehydration of ~2% body mass. Subjects then consumed either no fluid (NF) or enough fluid (water, WAT; Gatorade®, GAT; or GoodSport™, GS) to replace 75% of lost body mass over 30 min. After a 30-min light-intensity warm-up (1.5 W·kg^-1) in a 35°C, 20% RH environment, subjects then completed a 120-kJ time trial (TT). TT time-to-completion, absolute power, and relative power were significantly improved in WAT (535 ± 214 s, 259 ± 99 W, 3.3 ± 0.9 W·kg^-1), GAT (539 ± 226 s, 260 ± 110 W, 3.3 ± 1.0 W·kg^-1), and GS (534 ± 238 s, 262 ± 105 W, 3.4 ± 1.0 W·kg^-1) compared to NF (631 ± 310 s, 229 ± 96 W, 3.0 ± 0.9 W·kg^-1) all (p < 0.01) with no differences between WAT, GAT, and GS, suggesting that hydration is more important than carbohydrate availability during exercise in the heat. A subset of four subjects returned to the laboratory to repeat the WAT, GAT, and GS treatments to determine if between-beverage differences in time-trial performance were evident with a longer TT in thermoneutral conditions. Following dehydration, the ambient conditions in the environmental chamber were reduced to 21°C and 20% RH and subjects completed a 250-kJ TT. All four subjects improved TT performance in the GS trial (919 ± 353 s, 300 ± 100 W, 3.61 ± 0.86 W·kg^-1) compared to WAT (960 ± 376 s, 283 ± 91 W, 3.43 ± 0.83 W·kg^-1), while three subjects improved TT performance in the GAT trial (946 ± 365 s, 293 ± 103 W, 3.60 ± 0.97 W·kg^-1) compared to WAT, highlighting the importance of carbohydrate availability in cooler conditions as the length of a push-to-the-finish cycling task increases.

Bioaccessibility and Bioavailability of Minerals in Relation to a Healthy Gut Microbiome

Adequate amounts of a wide range of micronutrients are needed by body tissues to maintain health. Dietary intake must be sufficient to meet these micronutrient requirements. Mineral deficiency does not seem to be the result of a physically active life or of athletic training but is more likely to arise from disturbances in the quality and quantity of ingested food. The lack of some minerals in the body appears to be symbolic of the modern era reflecting either the excessive intake of empty calories or a negative energy balance from drastic weight-loss diets. Several animal studies provide convincing evidence for an association between dietary micronutrient availability and microbial composition in the gut. However, the influence of human gut microbiota on the bioaccessibility and bioavailability of trace elements in human food has rarely been studied. Bacteria play a role by effecting mineral bioavailability and bioaccessibility, which are further increased through the fermentation of cereals and the soaking and germination of crops. Moreover, probiotics have a positive effect on iron, calcium, selenium, and zinc in relation to gut microbiome composition and metabolism. The current literature reveals the beneficial effects of bacteria on mineral bioaccessibility and bioavailability in supporting both the human gut microbiome and overall health. This review focuses on interactions between the gut microbiota and several minerals in sport nutrition, as related to a physically active lifestyle.

Addition of an Alginate Hydrogel to a Carbohydrate Beverage Enhances Gastric Emptying

PURPOSE

This study aimed to examine the effect of altering osmolality or adding sodium alginate and pectin to a concentrated carbohydrate (CHO) beverage on gastric-emptying (GE) rate.

METHODS

Boluses (500 mL) of three drinks were instilled double blind in eight healthy men while seated, GE was measured using the double sampling method for 90 min, and blood samples were collected regularly. Drinks consisted of glucose and fructose (MON; 1392 mOsmol·kg), maltodextrin and fructose (POLY; 727 mOsmol·kg), and maltodextrin, fructose, sodium alginate, and pectin (ENCAP; 732 mOsmol·kg) with each providing 180 g·L CHO (CHO ratio of 1:0.7 maltodextrin or glucose/fructose).

RESULTS

Time to empty half of the ingested bolus was faster for ENCAP (21 ± 9 min) than for POLY (37 ± 8 min); both were faster than MON (51 ± 15 min). There were main effects for time and drink in addition to an interaction effect for the volume of test drink remaining in the stomach over the 90 min period, but there were no differences between MON and POLY at any time point. ENCAP had a smaller volume of the test drink in the stomach than MON at 30 min (193 ± 62 vs 323 ± 54 mL), which remained less up to 60 min (93 ± 37 vs 210 ± 88 mL). There was a smaller volume of the drink remaining in the stomach in ENCAP compared with POLY 20 min (242 ± 73 vs 318 ± 47 mL) and 30 min (193 ± 62 vs 304 ± 40 mL) after ingestion. Although there was a main effect of time, there was no effect of drink or an interaction effect on serum glucose, insulin or nonesterified fatty acid concentrations.

CONCLUSION

The addition of sodium alginate and pectin to a CHO beverage enhances early GE rate but did not affect serum glucose, insulin, or nonesterified fatty acid concentration at rest.

The Competition-Day Preparation Strategies of Strongman Athletes

Winwood, PW, Pritchard, HJ, Wilson, D, Dudson, M, and Keogh, JWL. The competition-day preparation strategies of strongman athletes. J Strength Cond Res 33(9): 2308-2320, 2019-This study provides the first empirical evidence of the competition-day preparation strategies used by strongman athletes. Strongman athletes (n = 132) (mean ± SD: 33.7 ± 8.1 years, 178.2 ± 11.1 cm, 107.0 ± 28.6 kg, 12.8 ± 8.0 years general resistance training, 5.9 ± 4.8 years strongman implement training) completed a self-reported 4-page internet survey on their usual competition-day preparation strategies. Analysis of the overall group and by sex, age, body mass, and competitive standard was conducted. Ninety-four percent of strongman athletes used warm-ups in competition, which were generally self-directed. The typical warm-up length was 16.0 ± 8.9 minutes, and 8.5 ± 4.3 minutes was the perceived optimal rest time before the start of an event. The main reasons for warming up were injury prevention, to increase activation, and increase blood flow/circulation, temperature, and heart rate. Athletes generally stated that competition warm-ups were practiced in training. Dynamic stretching, foam rolling, and myofascial release work were performed during warm-ups. Warm-up intensity was monitored using the rate of perceived exertion, perceived speed of movement, and training load (as a percentage of 1 repetition maximum). Cognitive strategies were used to improve competition performance, and psychological arousal levels needed to increase or be maintained in competition. Electrolyte drinks, caffeine, and preworkout supplements were the commonly used supplements. These data will provide strongman athletes and coaches some insight into common competition-day preparation strategies, which may enhance competition performances. Future research could compare different competition-day preparation strategies in an attempt to further improve strongman competition performance and injury prevention.

Ultra-endurance events in tropical environments and countermeasures to optimize performances and health

Physical performance in a tropical environment, combining high heat and humidity, is a difficult physiological challenge that requires specific preparation. The elevated humidity of a tropical climate impairs the thermoregulatory mechanisms by limiting the rate of sweat evaporation. Hence, a proper management of whole-body temperature is required to complete an ultra-endurance event in such an environment. In these long-duration events, which can last from 8 to 20 h, held in hot and humid settings, performance is tightly linked to the ability in maintaining an optimal hydration status. Indeed, the rate of withdrawal in these longer races was associated with lower water intake, and the majority of finishers exhibited alterations in electrolyte balance (e.g., sodium). Hence, this work reviews the effects on performance of high heat and humidity in two representative ultra-endurance sports, ultramarathons and long-distance triathlons, and several countermeasures to counteract the impact of these harsh environmental stresses and maintain a high level of performance, such as hydration, cooling strategies and heat acclimation.

The effects of intravenous dextrose 5%, Ringer's solution, and oral intake on the duration of labor stages in nulliparous women: a double-blind, randomized, controlled trial

Background and objectives: Childbirth consists of a three-stage period beginning with uterine contractions and ending in the expulsion of the placenta. The present study was conducted to compare the effects of Ringer's solution, dextrose solution 5%, and oral intake on the duration of total labor and labor stages (primary outcome) and the frequency of oxytocin administration and prolonged labor (secondary outcome) in nulliparous women with spontaneous vaginal delivery.Materials and methods: The present randomized clinical trial was conducted on 201 nulliparous women in labor assigned with a randomized block design to three groups, each receiving either Ringer's solution plus oral fluids, dextrose solution 5% solution plus oral fluids or oral fluids alone. The solutions were intravenously administered at a rate of 125 ml/h in the groups receiving the solutions and the subjects in the oral fluids group could consume liquids of their choice (water, orange juice, and apple juice). The duration of total labor and labor stages (the active stage, the second, and third stages of labor) were recorded by the researcher in minutes. Furthermore, the frequency of oxytocin administration and prolonged labor were recorded by the researcher by using a checklist. Data were analyzed using the Kruskal-Wallis test, Mann-Whitney's U-test, chi- square test and Fisher exact test.Results: The mean (±SD) duration of total labor was 301.2 (±50.0) minutes in the Ringer group, 171.9 (±36.4) in the dextrose 5% group, and 524.8 (±103.4) in the oral fluids group, suggesting a statistically significant intergroup difference (p < .001). The mean (±SD) duration of the active stage of labor was 276.7 (±91.3) minutes in the Ringer group, 150.6 (±78.5) in the dextrose 5% group, and 302.4 (±136.8) in the oral fluids group, suggesting a statistically significant intergroup difference (p < .001). A significant difference was also observed between the three groups in terms of the duration of the third stage of labor (p < .001); however, no significant differences were observed in terms of the duration of the second stage of labor (p = .058). Furthermore, a significant difference was observed between the three groups in terms of the need for oxytocin administration (p ≤ .001) and the frequency of prolonged labor (p = .001).Conclusion: The results suggest that the consumption of dextrose solution by nulliparous women reduces the duration of labor, the need for oxytocin administration and the frequency of prolonged labor compared to when Ringer's solution and oral fluids are used.

ISSN exercise & sports nutrition review update: research & recommendations

Background

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. In the year 2017 alone, 2082 articles were published under the key words ‘sport nutrition’. Consequently, staying current with the relevant literature is often difficult.

Methods

This paper is an ongoing update of the sports nutrition review article originally published as the lead paper to launch the Journal of the International Society of Sports Nutrition in 2004 and updated in 2010. It presents a well-referenced overview of the current state of the science related to optimization of training and performance enhancement through exercise training and nutrition. Notably, due to the accelerated pace and size at which the literature base in this research area grows, the topics discussed will focus on muscle hypertrophy and performance enhancement. As such, this paper provides an overview of: 1.) How ergogenic aids and dietary supplements are defined in terms of governmental regulation and oversight; 2.) How dietary supplements are legally regulated in the United States; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of nutritional approaches to augment skeletal muscle hypertrophy and the potential ergogenic value of various dietary and supplemental approaches.

Conclusions

This updated review is to provide ISSN members and individuals interested in sports nutrition with information that can be implemented in educational, research or practical settings and serve as a foundational basis for determining the efficacy and safety of many common sport nutrition products and their ingredients.

A randomized, double-blinded, controlled trial of the effects of fluid rate and/or presence of dextrose in intravenous fluids on the labor course of nulliparas

BACKGROUND

Prolonged labor has been demonstrated to increase adverse maternal and neonatal outcome. A practice that may decrease the risk of prolonged labor is the modification of fluid intake during labor.

OBJECTIVE

Several studies demonstrated that increased hydration in labor as well as addition of dextrose-containing fluids may be associated with a decrease in length of labor. The purpose of our study was to characterize whether high-dose intravenous fluids, standard-dose fluids with dextrose, or high-dose fluids with dextrose show a difference in the duration of labor in nulliparas.

STUDY DESIGN

Nulliparous subjects with singletons who presented in active labor were randomized to 1 of 3 groups of intravenous fluids: 250 mL/h of normal saline, 125 mL/h of 5% dextrose in normal saline, or 250 mL/h of 2.5% dextrose in normal saline. The primary outcome was total length of labor from initiation of intravenous fluid in vaginally delivered subjects. Secondary outcomes included cesarean delivery rate and length of second stage of labor, among other maternal and neonatal outcomes.

RESULTS

In all, 274 subjects who met inclusion criteria were enrolled. There were no differences in baseline characteristics among the 3 groups. There was no difference in the primary outcome of total length of labor in vaginally delivered subjects among the 3 groups. First stage of labor duration, second stage of labor duration, and cesarean delivery rates were also equivalent. There were no differences identified in other secondary outcomes including clinical chorioamnionitis, postpartum hemorrhage, blood loss, Apgar scores, or neonatal intensive care admission.

CONCLUSION

There is no difference in length of labor or delivery outcomes when comparing high-dose intravenous fluids, addition of dextrose, or use of high-dose intravenous fluids with dextrose in nulliparous women who present in active labor.

The effect of mineral-based alkaline water on hydration status and the metabolic response to short-term anaerobic exercise

Previously it was demonstrated that mineralization and alkalization properties of mineral water are important factors influencing acid-base balance and hydration in athletes. The purpose of this study was to investigate the effects of drinking different types of water on urine pH, specific urine gravity, and post-exercise lactate utilization in response to strenuous exercise. Thirty-six male soccer players were divided into three intervention groups, consuming around 4.0 l/day of different types of water for 7 days: HM (n=12; highly mineralized water), LM (n=12; low mineralized water), and CON (n=12; table water). The athletes performed an exercise protocol on two occasions (before and after intervention). The exercise protocol consisted of 5 bouts of intensive 60-s (120% VO_2max) cycling separated by 60 s of passive rest. Body composition, urinalysis and lactate concentration were evaluated – before (t0), immediately after (t1), 5’ (t2), and 30’ (t3) after exercise. Total body water and its active transport (TBW – total body water / ICW – intracellular water / ECW – extracellular water) showed no significant differences in all groups, at both occasions. In the post-hydration state we found a significant decrease of specific urine gravity in HM (1021±4.2 vs 1015±3.8 g/L) and LM (1022±3.1 vs 1008±4.2 g/L). We also found a significant increase of pH and lactate utilization rate in LM. In conclusion, the athletes hydrated with alkaline, low mineralized water demonstrated favourable changes in hydration status in response to high-intensity interval exercise with a significant decrease of specific urine gravity, increased urine pH and more efficient utilization of lactate after supramaximal exercise.

Effects of amino acid derivatives on physical, mental, and physiological activities

Nutritional ergogenic aids have been in use for a long time to enhance exercise and sports performance. Dietary components that exhibit ergogenic activity are numerous and their consumption is common and popular among athletes. They often come under scrutiny by legal authorities for their claimed benefits and safety concerns. Amino acid derivatives are propagated as being effective aids to enhance physical and mental performance in many ways, even though studies have pointed out that individuals who are deficient are more likely to benefit from dietary supplementation of amino acid derivatives than normal humans. In this review, some of the most common and widely used amino acids derivatives in sports and athletics namely creatine, tyrosine, carnitine, HMB, and taurine have been discussed for their effects on exercise performance, mental activity as well as body strength and composition. Creatine, carnitine, HMB, and taurine are reported to delay the onset of fatigue, improve exercise performance, and body strength. HMB helps in increasing fat-free mass and reduce exercise induced muscle injury. Taurine has been found to reduce oxidative stress during exercise and also act as an antihypertensive agent. Although, studies have not been able to find any favorable effect of tyrosine administration on exercise performance, it has been proved to be very effective in fighting stress, improving mood and cognitive performance particularly in sleep-deprived subjects. While available data from published studies and findings are equivocal about the efficacy of creatine, tyrosine, and HMB, more comprehensive researches on carnitine and taurine are necessary to provide evidence for the theoretical basis of their ergogenic role in nutritional modification and supplementation.

Fueling the rugby player: maximizing performance on and off the pitch

Fueling the rugby athlete requires a sports nutrition plan that balances energy intake with energy output while providing the athlete with adequate fuel for recovery. The content and timing of meals are fundamental parts of a successful regimen and often require the athlete to participate in extensive planning and preparation to succeed. Carbohydrates, protein, and fat are the primary fuel of the rugby athlete's diet, and proper hydration is imperative to optimize performance. The use of dietary supplements such as energy drinks and caffeine are controversial, and the supplementation of vitamins and minerals is generally not recommended. The use of creatine monohydrate as a supplement to a well-balanced diet has been shown to be safe and effective. With the help of sports nutritionists, team physicians, educated athletes, and coaches, a multifactorial all-encompassing plan is required generally to maximize optimal performance on and off the rugby pitch.

Investigating the associations between hydration and exercise performance: methodology and limitations

Loss of body water, if sufficiently severe, impairs most physiological functions, but the body water content fluctuates over the course of a normal day with no implications for physical or mental performance. The point at which an effect of dehydration becomes apparent has been the subject of much debate, in part, at least, because of the different tests that have been applied, differences in the methodologies used to induce dehydration and also because of differences in the fitness and other physiological characteristics of the subjects studied. The act of drinking itself and the conscious denial of access to water will also have implications for subjective responses to the exercise task. In many published studies, it is difficult to separate the effects of ingestion of water from those of carbohydrate, electrolytes, and other drink components. Nevertheless, there is good evidence that drinking appropriate amounts of water, especially cold water, can enhance exercise performance in many situations.

A randomized controlled trial comparing parenteral normal saline with and without 5% dextrose on the course of labor in nulliparous women

OBJECTIVE

The objective of this study was to compare intravenous normal saline with and without 5% dextrose on the course of labor in nulliparous women in active phase of spontaneous labor.

STUDY DESIGN

In a randomized controlled trial, term, nulliparous women with singleton pregnancy in active labor were randomized into one of two groups receiving either normal saline or normal saline alternating with 5% dextrose at rate of 175 ml/h. The primary outcome was total length of labor from onset of study fluid in vaginally delivered women. Maternal and neonatal outcomes were also analyzed.

RESULTS

Of 250 women enrolled, in vaginally delivered subjects, there was significant difference in the duration of labor (p=0.0) and prolonged labor (p=0.01), with favorable results for women in 5% dextrose alternating with normal saline. No statistically significant differences were observed in the cesarean section rates between the groups. The cord pH was significantly higher in neonates born to women in 5% dextrose alternating with normal saline infusion as compared to normal saline alone (p=0.01), however, no neonate in the study had acidemia.

CONCLUSION

Administration of a 5% dextrose solution alternating with normal saline is a better parenteral fluid for significantly decreasing duration of labor in term vaginally delivered nulliparous women in spontaneous active labor as compared to normal saline alone.

Supplementation of Acqua Lete® (Bicarbonate Calcic Mineral Water) improves hydration status in athletes after short term anaerobic exercise

BACKGROUND

Experimental studies suggest that mineral waters with high concentrations of calcium and bicarbonate can impact acid-base balance. The purpose of this study was to test the effect on acid-base balance and specific urine gravity, of a bicarbonate calcic mineral water (Acqua Lete®) compared to a minimally mineralized water.

METHODS

88 amateur male athletes underwent two experimental trials with a modified Wingate test: the first was carried out without hydration (Control Test, Test C, n = 88); the second was carried out after one week of controlled hydration (Test with hydration, Test H, n = 88), with 1.5 L/day of a very low mineral content water (Group A, n = 44) or 1.5 L/day of Acqua Lete® (Group B, n = 44). Measure of body temperature, bioimpedance analysis, muscular ultrasound, and urinalysis were taken before (t0), immediately after (t1), 5' (t2), and 30' (t3) after exercise.

RESULTS

Hydration results in a decreased core temperature; muscular ultrasound showed increased muscle thickness after exercise related to content of body water. Regarding urinalysis, in test H, we found in both groups after exercise a significant decrease of specific urine gravity with significantly lower levels in Group B. We also found a significant increase of pH in the same Group B.

CONCLUSIONS

In conclusion all the athletes hydrated with Acqua Lete® showed a positive impact on hydration status after anaerobic exercise with significant decrease of specific urine gravity and a positive effect on pH.

A randomized controlled trial to study the effect of IV hydration on the duration of labor in nulliparous women

PURPOSE

To compare the effects of two different regimens of intravenous hydration and oral hydration on the duration of active labor.

METHODS

Two hundred and ninety-three low risk term primigravida in active labor were randomized into three groups. The first group had 99 patients who received oral fluids only, the second group of 98 patients received intravenous Ringer lactate at the rate of 125 ml/h (IV 125 ml) and the third group had 96 patients who received intravenous Ringer lactate at a rate of 250 ml/h (IV 250 ml). Amniotomy and oxytocin administration were allowed according to the physician's discretion.

RESULTS

The mean duration of labor in the oral fluid group was 391, 363 min in the 125 ml/h group and 343 min in the 250 ml/h group, P = 0.203. The incidence of prolonged labor more than 12 h in the oral fluid group was 7.1% in the oral fluid group, 4.1% in the 125 ml/h group and 3.1% in the 250 ml/h group, P = 0.402. The oxytocin requirement was 37% in the oral group, 32% in the 125 ml/h group and 33% in the 250 ml/h group, P = 0.68. There was a statistically significant reduction in the incidence of vomiting in patients receiving intravenous hydration, i.e. 24.2% in the oral group, 11.2% in the 125 ml/h group and 6.3% in the 250 ml/h group, P = 0.001. There was no difference in the mode of delivery, maternal or neonatal complications between the three groups.

CONCLUSION

This study establishes a trend towards decreased incidence of prolonged labor and less vomiting in patients receiving intravenous hydration.

Voluntary fluid intake, hydration status, and aerobic performance of adolescent athletes in the heat

We determined whether beverage flavoring and composition would stimulate voluntary drink intake, prevent dehydration, and maintain exercise performance in heat-acclimated adolescent males running in the heat. Eight adolescent (age, 13.7 ± 1.1 years) runners (peak oxygen uptake, 59.5 ± 4.0 mL·kg–1·min–1) underwent at least four 80-min exercise heat-acclimation sessions before completing 3 experimental sessions. All sessions were performed at 30 °C and 60%–65% relative humidity. Each experimental session consisted of five 15-min treadmill runs at a speed eliciting 65% peak oxygen uptake, with a 5 min rest prior to each run. Ten minutes after the final run, a time to exhaustion test was performed at a speed eliciting 90% peak oxygen uptake. Counterbalanced experimental sessions were identical, except for fluid intake, which consisted of tap water (W), flavored water (FW), and FW with 6% carbohydrate and 18 mmol·L–1 NaCl (CNa) consumed ad libitum. Fluid intake and body weight were monitored to calculate dehydration. Voluntary fluid intake was similar to fluid losses in W (1032 ± 130 vs. 1340 ± 246 g), FW (1086 ± 86 vs. 1451 ± 253 g), and CNa (1259 ± 119 vs. 1358 ± 234 g). As a result, significant dehydration was avoided in all trials (–0.45% ± 0.68% body weight in W, –0.66% ± 0.50% body weight in FW, and –0.13% ± 0.71% body weight in CNa). Core temperature increased by ~1 °C during exercise, but was not different between trials. Time to exhaustion was not different between trials and averaged 8.8 ± 1.7 min. Under exercise conditions more closely reflecting real-life situations, heat-acclimatized adolescent male runners can appropriately gauge fluid intake regardless of the type of beverage made available, resulting in consistency in exercise performance.

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients.

Fluid and food intake during professional men's and women's road-cycling tours

PURPOSE

To quantify the fluid and food consumed during a men's and women's professional road-cycling tour.

METHODS

Eight men (age 25 +/- 5 y, body mass 71.4 +/- 7.4 kg, and height 177.4 +/- 4.5 cm) and 6 women (age 26 +/- 4 y, body mass 62.5 +/- 5.6 kg, and height 170.4 +/- 5.2 cm) of the Australian Institute of Sport Road Cycling squads participated in the study. The men competed in the 6-d Tour Down Under (Adelaide, Australia), and the women, in the 10-d Tour De L'Aude (Aude, France). Body mass was recorded before and immediately after the race. Cyclists recalled the number of water bottles and amount of food they had consumed.

RESULTS

Men and women recorded body-mass losses of approximately 2 kg (2.8% body mass) and 1.5 kg (2.6% body mass), respectively, per stage during the long road races. Men had an average fluid intake of 1.0 L/h, whereas women only consumed on average 0.4 L/h. In addition, men consumed CHO at the rate suggested by dietitians (average CHO intake of 48 g/h), but again the women failed to reach recommendations, with an average intake of approximately 21 g/h during a road stage.

CONCLUSIONS

Men appeared to drink and eat during racing in accordance with current nutritional recommendations, but women failed to reach these guidelines. Both men and women finished their races with a body-mass loss of approximately 2.6% to 2.8%. Further research is required to determine the impact of this loss on road-cycling performance and thermoregulation.

A randomized, double-blinded, controlled trial comparing parenteral normal saline with and without dextrose on the course of labor in nulliparas

OBJECTIVE

The objective of the study was to compare intravenous normal saline with and without dextrose on the course of labor in nulliparae.

STUDY DESIGN

In a double-blinded, controlled trial, term, nulliparae with singletons in active labor were randomized into 1 of 3 groups receiving either normal saline (NS), NS with 5% dextrose (D5NS), or NS with 10% dextrose (D10NS) at 125 mL/h. The primary outcome was total length of labor from onset of study fluid in vaginally delivered subjects. Maternal and neonatal outcomes were also analyzed.

RESULTS

Of 300 subjects enrolled, 289 met inclusion criteria and completed the study. In vaginally delivered subjects, significant differences were noted in the second stage (P = .01) and total length of labor (P = .02). No significant differences were observed in the cesarean section rates between the groups (P = .21). No differences were noted in maternal or neonatal secondary outcomes.

CONCLUSION

Administration of a dextrose solution, regardless of concentration, was associated with a shortened labor course in term vaginally delivered nulliparae subjects in active labor.

Effects of acute dehydration on brain morphology in healthy humans

Dehydration can affect brain structure which has important implications for human health. In this study, we measured regional changes in brain structure following acute dehydration. Healthy volunteers received a structural MRI scan before and after an intensive 90-min thermal-exercise dehydration protocol. We used two techniques to determine changes in brain structure: a manual point counting technique using MEASURE, and a fully automated voxelwise analysis using SIENA. After the exercise regime, participants lost (2.2% +/- 0.5%) of their body mass. Using SIENA, we detected expansion of the ventricular system with the largest change occurring in the left lateral ventricle (P = 0.001 corrected for multiple comparisons) but no change in total brain volume (P = 0.13). Using manual point counting, we could not detect any change in ventricular or brain volume, but there was a significant correlation between loss in body mass and third ventricular volume increase (r = 0.79, P = 0.03). These results show ventricular expansion occurs following acute dehydration, and suggest that automated longitudinal voxelwise analysis methods such as SIENA are more sensitive to regional changes in brain volume over time compared with a manual point counting technique.

Voluntary drinking and hydration in non-acclimatized girls exercising in the heat

The intent of this study was to assess the influence of drink flavor and composition on voluntary drinking and hydration status in girls exercising intermittently in the heat (35 +/- 1 degrees C, 45-50% relative humidity). Twelve physically active, nonacclimatized girls (9-12 years) performed three 3 h identical sessions, each consisting of four 20 min cycling bouts at 50% (VO(2max)), separated by 25 min of rest. One of the three beverages (chilled to 8-10 degrees C) was assigned to each session: unflavored water (W), grape-flavored water (FW) and grape-flavored water plus 6% carbohydrate and 18 mmol l(-1) NaCl (CNa). Drinking was ad libitum. Body weight (BW), drink intake (DI), heart rate, rectal and skin temperatures, and perceptions of thirst and stomach fullness were monitored periodically. Total DI was 759, 940, 1,045 g in W, FW and CNa, respectively (P < 0.05 for CNa-W and FW-W). BW changes were -0.15, 0.16, and 0.45% in W, FW and CNa, respectively, but only the difference between CNa and W was significant (P < 0.05). Other physiological and perceptual variables were not different between trials. In conclusion, beverage flavoring regardless if its combination with carbohydrate and NaCl, mildly enhanced voluntary drinking in young non-acclimatized girls. In contrast to previous research in young boys, euhydration was maintained in the girls by an adequate intake of unflavored water.

The influence of drink temperature on thermoregulatory responses during prolonged exercise in a moderate environment

Nine males cycled at 53% (s = 2) of their peak oxygen uptake (VO(2peak)) for 90 min (dry bulb temperature: 25.4 degrees C, s = 0.2; relative humidity: 61%, s = 3). One litre of flavoured water at 10 (cold), 37 (warm) or 50 degrees C (hot) was ingested 30 - 40 min into exercise. Immediately after the 90 min of exercise, participants cycled at 95%VO(2peak) to exhaustion to assess exercise capacity. Rectal and mean skin temperatures and heart rate were recorded. The gradient of rise in rectal temperature was influenced (P < 0.01) by drink temperature. Mean skin temperature was highest in the hot trial (cold trial: 34.2 degrees C, s = 0.5; warm trial: 34.4 degrees C, s = 0.5; hot trial: 34.7 degrees C, s = 0.6; P < 0.01). Significant differences were observed in heart rate (cold trial: 132 beats . min(-1), s = 13; warm trial: 134 beats . min(-1), s = 12; hot trial: 139 beats . min(-1), s = 13; P < 0.05). Exercise capacity was similar between trials (cold trial: 234 s, s = 69; warm trial: 214 s, s = 52; hot trial: 203 s, s = 53; P = 0.562). The heat load and debt induced via drinking resulted in appropriate thermoregulatory reflexes during exercise leading to an observed heat content difference of only 33 kJ instead of the predicted 167 kJ between the cold and hot trials. These results suggest that there may be a role for drink temperature in influencing thermoregulation during exercise.

Fluid and fuel intake during exercise

The amounts of water, carbohydrate and salt that athletes are advised to ingest during exercise are based upon their effectiveness in attenuating both fatigue as well as illness due to hyperthermia, dehydration or hyperhydration. When possible, fluid should be ingested at rates that most closely match sweating rate. When that is not possible or practical or sufficiently ergogenic, some athletes might tolerate body water losses amounting to 2% of body weight without significant risk to physical well-being or performance when the environment is cold (e.g. 5-10 degrees C) or temperate (e.g. 21-22 degrees C). However, when exercising in a hot environment ( > 30 degrees C), dehydration by 2% of body weight impairs absolute power production and predisposes individuals to heat injury. Fluid should not be ingested at rates in excess of sweating rate and thus body water and weight should not increase during exercise. Fatigue can be reduced by adding carbohydrate to the fluids consumed so that 30-60 g of rapidly absorbed carbohydrate are ingested throughout each hour of an athletic event. Furthermore, sodium should be included in fluids consumed during exercise lasting longer than 2 h or by individuals during any event that stimulates heavy sodium loss (more than 3-4 g of sodium). Athletes do not benefit by ingesting glycerol, amino acids or alleged precursors of neurotransmitter. Ingestion of other substances during exercise, with the possible exception of caffeine, is discouraged. Athletes will benefit the most by tailoring their individual needs for water, carbohydrate and salt to the specific challenges of their sport, especially considering the environment's impact on sweating and heat stress.

Sodium Loading Aids Fluid Balance and Reduces Physiological Strain of Trained Men Exercising in the Heat

PURPOSE

This study was conducted to determine whether preexercise ingestion of a highly concentrated sodium beverage would increase plasma volume (PV) and reduce the physiological strain of moderately trained males running in the heat.

METHODS

Eight endurance-trained (.VO2max: 58 mL.kg(-1).min(-1) (SD 5); 36 yr (SD 11)) runners completed this double-blind, crossover experiment. Runners ingested a high-sodium (High Na+: 164 mmol Na+.L(-1)) or low-sodium (Low Na+: 10 mmol Na+.L(-1)) beverage (10 mL.kg(-1)) before running to exhaustion at 70% .VO2max in warm conditions (32 degrees C, 50% RH, V(a) approximately equal to 1.5 m.s(-1)). Beverages (approximately 757 mL) were ingested in seven portions across 60 min beginning 105 min before exercise. Trials were separated by 1-3 wk. Heart rate and core and skin temperatures were measured throughout exercise. Urine and venous blood were sampled before and after drinking and exercise.

RESULTS

High Na+ increased PV before exercise (4.5% (SD 3.7)), calculated from Hct and [Hb]), whereas Low Na+ did not (0.0% (SD 0.5); P = 0.04), and involved greater time to exercise termination in the six who stopped because of an ethical end point (core temperature 39.5 degrees C: 57.9 min (SD 6) vs 46.4 min (SD 4); P = 0.04) and those who were exhausted (96.1 min (SD 22) vs 75.3 min (SD 21); P = 0.03; High Na+ vs Low Na+, respectively). At equivalent times before exercise termination, High Na+ also resulted in lower core temperature (38.9 vs 39.3 degrees C; P = 0.00) and perceived exertion (P = 0.01) and a tendency for lower heart rate (164 vs 174 bpm; P = 0.08).

CONCLUSIONS

Preexercise ingestion of a high-sodium beverage increased plasma volume before exercise and involved less thermoregulatory and perceived strain during exercise and increased exercise capacity in warm conditions.

Increased intravenous fluid intake and the course of labor in nulliparous women

OBJECTIVE

To compare the effect of 2 regimens of intravenous fluid therapy on the course of labor.

METHODS

In a prospective, randomized, double-blind study of 300 nulliparous pregnant women at term conducted at a teaching hospital, 153 women received 125 mL and 147 received 250 mL of intravenous fluid per hour. The groups were matched and analysis was done using the t, chi(2), and Fisher exact tests. P<0.05 was considered statistically significant.

RESULTS

In the group that received intravenous fluid at a rate of 250 mL per hour the mean+/-S.D. duration of labor was significantly shorter (253+/-97 vs. 386+/-110 min; P = 0.0001), the frequency of labor lasting both more than 10h and more than 15 h was statistically lower (4.8% vs. 13.8%; P=0.001 and 0% vs. 4.5%; P=0.02, respectively), and the frequency of oxytocin administration was significantly lower (8.1% vs. 20.4%; P=0.001). There was a trend toward a lower frequency of cesarean deliveries in the 250-mL group (16% vs. 22.8%; P=0.1).

CONCLUSION

A greater volume per hour of intravenous fluid than is commonly administered to nulliparous women in active labor is associated with significantly shorter duration of labor and lower frequency of both prolonged labor and oxytocin administration.

[Scintigraphic study of gastric emptying of rehydration drinks in athletes]

This study aims to evaluate how rehydration beverage ingestion influences gastric emptying rate (in cycle ergometer) at rest and during exercise at 70 % of maximal oxygen consumption (VO2max).

MATERIAL AND METHOD

26 well-trained cyclists performed a preliminary maximal test until exhaustion to evaluate their VO2max, and two submaximal exercise tests at 70 % of their mode-specific VO2max. Each test was separated by one week. During the two submaximal tests, cyclists consumed 200 ml of a 99mTc-DTPA labeled rehydration beverage (A or B) and scintigraphy determinations were performed at rest. After, exercise was initiated for 60 minutes with an intake rate of 200 ml every 15 minutes, making gastric serial scintigraphy determinations. The difference regarding chemical composition between A and B drinks resides in the fact that drink A contains a smaller load in carbohydrates (10.3 g/100 ml versus 15.2 g/100 ml of B), proteins in form of serum milk and antioxidants in form of fruit juice. Both contain ions and vitamins.

RESULTS

at rest, gastric count number was significantly reduced (p > 0.000) from 0 to 25 minutes for both A and B beverage. At the end of exercise (60 min), there was greater gastric retention for B beverage than for A, this difference being statistically significant (p < 0.031).

CONCLUSIONS

The A beverage, a rehydration drink on the market with protein and antioxidants with fruit juice content, has a faster gastric emptying rate than the B sport beverage.

ISSN Exercise & Sport Nutrition Review: Research & Recommendations

Sport nutrition is a constantly evolving field with literally thousands of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper presents a well-referenced overview of the current state of the science related to how to optimize training through nutrition. More specifically, this article discusses: 1.) how to evaluate the scientific merit of nutritional supplements; 2.) general nutritional strategies to optimize performance and enhance recovery; and, 3.) our current understanding of the available science behind weight gain, weight loss, and performance enhancement supplements. Our hope is that ISSN members find this review useful in their daily practice and consultation with their clients.

Maintaining Fluid and Electrolyte Balance During Exercise

The well-documented benefits and popularity of sports and fitness have led to an increased demand for products that not only replace sweat losses but also provide fuel for continued high-intensity metabolic demands. The twin risks of hypohydration and hyponatremia can lead to morbid and even fatal outcomes if rational replacement regimens are not followed, especially in endurance athletes and during hot or humid conditions. The avoidance of these complications of physical activity with oral replacement products has been documented primarily in high-impact, prolonged-duration events. Replacement fluid should contain water, sodium, and perhaps potassium to avoid overhydration-induced hyponatremia. Carbohydrates are added if muscle exertion is to continue for prolonged periods (>60 minutes in duration). The overuse of oral replacement products may yield the dilution of serum and intracellular electrolytes, hyperglycemia, and gastrointestinal distress. Baseline hydration and glucose status should be optimized before activity, and alterations in the amount and type of fluid ingested may be required for special populations such as children and individuals with chronic disease.

Effects of dietary fat and endurance exercise on plasma cortisol, prostaglandin E2, interferon-gamma and lipid peroxides in runners

OBJECTIVE

Exercise and the neuroendocrine and oxidative stress it elicits on immune function is modulated by dietary fat intake. The effects of increasing dietary fat on endurance exercise-induced alterations 80% of VO2max for 2 hours) in the plasma levels of cortisol and prostaglandin E2 (PGE2), interferon-gamma (IFN-gamma) and lipid peroxides were investigated. As higher levels of cortisol, PGE2 and lipid peroxides could be immunosuppressive, the effects of different levels of dietary fat on these measures in runners were determined.

METHODS

Healthy trained runners (males and females) consumed serially 15% fat diet (of daily energy), 30% fat diet and 40% fat diets for four weeks each. In the last week of each diet period the subjects ran to exhaustion at 80% of their VO2max and blood was drawn pre- and post-run. Cortisol, IFN-gamma, PGE2 and lipid peroxides were determined using standard techniques.

RESULTS

Pre-exercise levels of plasma cortisol were elevated, IFN-gamma was unchanged and PGE2 and lipid peroxides decreased on the 40%F diet compared to 30%F and 15%F. Post-exercise levels of plasma cortisol (p < 0.004), PGE2 (p < 0.0057) and lipid peroxide levels increased (p < 0.0001) after endurance exercise on all diets. The rates of increase of plasma cortisol levels during exercise were similar on all three diets. Although absolute cortisol levels were higher in the high fat group, the rate of increase of plasma cortisol level during exercise was similar on each diet. The dietary fat levels did not affect IFN-gamma, however, PGE2 and lipid peroxides decreased with increasing fat at baseline at 40%F level (p < 0.01; 30%F vs. 40% F: p < 0.002; 15%F vs. 40%F: p < 0.007).

CONCLUSIONS

Data from the present study suggest that higher levels of fat in the diet, up to 40%, increase endurance running time without adverse effects on plasma cortisol, IFN-gamma, and lipid peroxide levels.

Exogenous carbohydrate oxidation from drinks ingested during prolonged exercise in a cold environment in humans

Six healthy male volunteers performed four rides to exhaustion on a cycle ergometer at approximately 80% of maximal oxygen consumption. Subjects ingested a bolus volume of fluid (7.14 ml/kg) immediately before exercise and additional fluid volumes (1.43 ml/kg) every 10 min during exercise. The fluids ingested were either a flavored water control or glucose-electrolyte beverages with glucose concentrations of 2, 6, or 12%. The beverages were labeled with [U-(13)C]glucose (99.2%: 0.05 g/l). Exercise capacity was not different (P = 0.13) between trials; median (range) exercise time was 83.52 (79.85--89.68), 103.19 (78.82--108.22), 100.37 (80.60--124.07), and 94.76 (76.78--114.25) min in the 0, 2, 6, and 12% trials, respectively. The oxidation of exogenous glucose in each 15-min period was significantly lower in the 2% trial (P = 0.02) than in the 6 and 12% trials where oxidation rates were between 0.5 and 0.7 g/min. No difference in endogenous glucose oxidation was observed between trials (P = 0.71). These findings indicate that the oxidation of exogenous glucose during exercise of this intensity and duration in a cold environment is similar to that observed in warmer conditions. Thus a low oxidation of exogenous substrate is unlikely to be a factor limiting the effectiveness of carbohydrate-electrolyte drink ingestion on exercise capacity in a cold environment.

A randomized controlled trial of the effect of increased intravenous hydration on the course of labor in nulliparous women

OBJECTIVE

One variable that has the potential to affect the course of labor but has not been evaluated previously is the adequacy of maternal hydration. Typical orders provide for 125 mL of intravenous fluids per hour in patients taking limited oral fluids. Many such patients are clinically dehydrated. Physiologists have shown that increased fluids improve skeletal muscle performance in prolonged exercise. This study was designed to determine whether increased intravenous fluids affect the progress of labor.

STUDY DESIGN

Nulliparous women with uncomplicated singleton gestations at term, in spontaneous active labor with dilatation between 2 and 5 cm, and with a cephalic presentation were included. Patients who gave consent were randomly selected to receive either 125 mL or 250 mL of intravenous fluids per hour.

RESULTS

One hundred ninety-five patients were randomly selected, 94 to the 125-mL group and 101 to the 250-mL group. Prerandomization variables were well matched between the 2 groups. The mean volume of total intravenous fluids was significantly greater in the 250-mL group (2008 mL vs 2487 mL; P =.002), as was the mean hourly rate (152 mL/h in the 125-mL group vs 254 mL/h in the 250-mL group; P =.001). The frequency of labor lasting >12 hours was statistically higher in the 125-mL group (20/78 [26%] vs 12/91 [13%]; P =.047). In addition, there was a trend favoring longer mean duration of the first stage and total duration of labor in patients delivered vaginally in the 125-mL group, by 70 and 68 minutes, respectively (P =.06). There was a trend toward a lower frequency of oxytocin administration for inadequate labor progress in the higher fluid rate group (61 [65%] in the 125-mL group vs 51 [49%] in the 250-mL group; P =.06). Cesarean deliveries were more frequent in the 125-mL group (n = 16) than in the 250-mL group (n = 10) but did not reach statistical significance.

CONCLUSION

This study presents the novel finding that increasing fluid administration for nulliparous women in labor above rates commonly used is associated with a lower frequency of prolonged labor and possibly less need for oxytocin. Thus inadequate hydration in labor may be a factor contributing to dysfunctional labor and possibly cesarean delivery. Consideration of this factor in clinical management and in future studies considering variables that affect labor is warranted.

The effectiveness of commercially available sports drinks

The purpose of this review is to evaluate the effectiveness of commercially available sports drinks by answering the questions: (i) will consuming a sports drink be beneficial to performance? and (ii) do different sports drinks vary in their effectiveness? To answer these questions we have considered the composition of commercially available sports drinks, examined the rationale for using them, and critically reviewed the vast number of studies that have investigated the effectiveness of sports drinks on performance. The focus is on the drinks that contain low carbohydrate concentrations (<10%) and are marketed for general consumption before and during exercise rather than those with carbohydrate concentrations >10%, which are intended for carbohydrate loading. Our conclusions are 3-fold. First, because of variations in drink composition and research design, much of the sports drinks research from the past cannot be applied directly to the effectiveness of currently available sports drinks. Secondly, in studies where a practical protocol has been used along with a currently available sports beverage, there is evidence to suggest that consuming a sports drinks will improve performance compared with consuming a placebo beverage. Finally, there is little evidence that any one sports drink is superior to any of the other beverages on the market.

Intermittent running: muscle metabolism in the heat and effect of hypohydration

PURPOSE

This study reports two studies that investigated the reason for a poorer intermittent supramaximal running performance previously found in the heat (Maxwell et al., The effect of climatic heat stress on intermittent supramaximal running performance in humans. Exp. Physiol. 81:833-845, 1996). The first study tested the hypothesis that it was due to different rates of substrate metabolism. The second study tested whether a greater level of hypohydration led to an earlier exhaustion time.

METHODS

A maximal anaerobic running test (MART) was the exercise model used. This involved repeated 20-s runs, each at increasing intensities, with 100 s of passive recovery between runs.

RESULTS

In study 1, eight male subjects performed the MART on two occasions at either 32.8+/-0.3 degrees C, 80.5+/-1.6% relative humidity (RH), or 21.3+/-0.4 degrees C, 48.8+/-2.2% RH. Needle biopsy samples were taken from the vastus lateralis muscle before and immediately after the MART. In study 2, 11 male subjects performed the MART in a moderately hypohydrated (HYPO) and euhydrated (EUH) state while in a cool environment. In study 1, performance was significantly worse in the hot compared with the cool environment (138+/-7 vs. 150+/-6 s, respectively, P<0.05). No differences were observed in the change in muscle glycogen (100.3+/-15.1 vs. 107.0+/-15.6 mmol glucosyl units x kg dry muscle(-1)) or muscle lactate (102.9+/-18.2 vs. 100.5+/-16.6 mmol x kg dry muscle(-1)) between the hot and cool environments, respectively. In study 2, performance was worse in the HYPO (148+/-9 s) compared with the EUH (154+/-9 s) trial (P<0.05).

CONCLUSIONS

These results indicate that a reduced intermittent supramaximal running performance in the heat is not caused by greater muscle glycogenolysis or lactate accumulation. Further, a poorer intermittent sprinting performance is experienced in a hypohydrated compared with a euhydrated state.

Fluid replacement needs of well-trained male and female athletes during indoor and outdoor steady state running

Twelve male and six female well-trained middle distance athletes performed a series of six one hour runs at 75% VO2 peak pace under similar environmental states indoors (treadmill) and outdoors (track). Running was undertaken in control (C, no fluid), followed by water (W) and sports drink (SD) treatments, with each run separated by a one week interval. Both fluid treatments were supplied in volumes equivalent to individual body mass (fluid) losses incurred in the respective indoor and outdoor C treatments. Haemodynamic (plasma volume), physiological (heart rate and body temperature) and blood chemistry (blood lactate and glucose) measures were analysed as pre to post run changes (delta values). During the respective indoor and outdoor C treatments, males demonstrated approximately a twofold change in body mass (fluid) losses (delta 1.81 +/- 0.10 kg and 2.06 +/- 0.13 kg) compared with females (delta 0.93 +/- 0.11 kg and 1.32 +/- 0.12 kg) (all p<0.05). These losses resulted in almost a twofold fluid replacement need relative to body mass during the running phases of respective indoor and outdoor W and SD treatments in males compared with females (all p<0.05). Both W and SD treatments were effective in minimising the pre to post run disturbances in plasma volume, heart rate, body temperature and blood lactate, while SD treatment resulted in enhanced blood glucose changes. The results suggest gender specific differences in fluid replacement needs during steady state running, which need to be incorporated into fluid replacement strategies to compensate for the demands of training and competition in middle distance athletic events.

Functional food science and substrate metabolism

The present review addresses the role of food constituents in the aetiology of metabolic conditions and chronic diseases, mostly related to energy metabolism and substrate regulation, such as obesity and non-insulin-dependent diabetes mellitus. Second, attention is paid to malnutrition, a major cause of mortality and morbidity in developing countries, which may be a cause of concern in Europe because of the increasing number of elderly people in the population. Finally, the role of diet during exercise, a condition of enormous substrate demands, is evaluated. Based on a critical evaluation of the existing knowledge in the literature, implications for future research in relation to functional foods are discussed.

Fluid and carbohydrate replacement during intermittent exercise

Most studies relating to fluid replacement have addressed the problem of drinking during prolonged exercise. Fluid replacement is also very important for intermittent exercise, although it has not been extensively studied. More studies in this area would help coaches and athletes understand the importance of fluid balance and carbohydrate supplementation during intermittent exercise. Based on available data, it can be concluded that: (i) because of high exercise intensity, sweat loss and glycogen depletion during intermittent exercise are at least comparable with those during continuous exercise for a similar period of time. Therefore, the need to ingest a sport drink or replacement beverage during intermittent exercise may be greater than that during continuous exercise in order to maintain a high level of performance and to help prevent the possibility of thermal injury when such activity occurs in a warm environment; (ii) the volume of ingested fluid is critical for both rapid gastric emptying and complete rehydration; and (iii) osmolality (250 to 370 mOsm/kg), carbohydrate concentration (5 to 7%), and carbohydrate type (multiple transportable carbohydrates) should be considered when choosing an effective beverage for rehydration and carbohydrate supplementation during intermittent exercise.

Influence of ingesting a carbohydrate-electrolyte solution on endurance capacity during intermittent, high-intensity shuttle running

The aim of this study was to examine the effects of ingesting a carbohydrate-electrolyte solution on endurance capacity during a prolonged intermittent, high-intensity shuttle running test (PIHSRT). Nine trained male games players performed two exercise trials, 7 days apart. On each occasion, they completed 75 min exercise, comprising of five 15-min periods of intermittent running, consisting of sprinting, interspersed with periods of jogging and walking (Part A), followed by intermittent running to fatigue (Part B). The subjects were randomly allocated either a 6.9% carbohydrate-electrolyte solution (CHO) or a non-carbohydrate placebo (CON) immediately prior to exercise (5 ml kg-1 body mass) and every 15 min thereafter (2 ml kg-1 body mass). Venous blood samples were obtained at rest, during and after each PIHSRT for the determination of glucose, lactate, plasma free fatty acid, glycerol, ammonia, and serum insulin and electrolyte concentrations. During Part B, the subjects were able to continue running longer when fed CHO (CHO = 8.9 +/- 1.5 min vs CON = 6.7 +/- 1.0 min; P < 0.05) (mean +/- S.E.M.). These results show that drinking a carbohydrate-electrolyte solution improves endurance running capacity during prolonged intermittent exercise.

Comparison between carbohydrate feedings before and during exercise on running performance during a 30-km treadmill time trial

The purpose of this study was to compare the effects of a carbohydrate-electrolyte solution, ingested during exercise, with the effects of a preexercise carbohydrate meal on endurance running performance. Ten endurance-trained males completed two 30-km treadmill runs. In one trial subjects consumed a placebo solution 4 hr before exercise and a carbohydrate-electrolyte solution immediately before exercise and every 5 km (C). In the other trial, subjects consumed a 4-hr preexercise high-carbohydrate meal and water immediately before exercise and every 5 km (M). Performance times were identical for M and C, and there was no difference in the self-selected speeds. Oxygen uptake, heart rates, perceived rate of exertion, and respiratory exchange ratios were also similar. However, blood glucose concentration was higher in C during the first 20 km of the 30-km run. In M, blood glucose concentration was maintained above 4.5 mmol.L-1 throughout exercise. Thus, the two conditions produced the same 30-km treadmill running performance time.

Drinking behavior and exercise-thermal stress: role of drink carbonation

This study investigated the influence of drink carbonation and carbohydrate content on ad libitum drinking behavior and body fluid and electrolyte responses during prolonged exercise in the heat. Eight competitive male runners completed three 2-hr treadmill runs at 60% VO2max in an environmental chamber maintained at 30 degrees C and 40% RH. Three test drinks were used: 8% carbohydrate, low carbonation (8%-C); 8% carbohydrate, noncarbonated (8%-NC), and water (0%-NC). Blood samples were taken preexercise (0), at 60 and 120 min of exercise, and at 60 min of recovery (+60 min). The data suggest that while reports of heartburn tend to be higher on 8% carbohydrate drinks than on 0%-NC, this does not appear to be a function of drink carbonation. Similarly, the increased frequency of heartburn did not significantly reduce fluid consumption either during exercise or during a 60-min recovery period. Importantly, no differences were observed between fluid and electrolyte, or thermoregulatory responses to the three sport drinks. Thus, consumption of low-carbonation beverages does not appear to significantly influence drinking behavior or the related physiological responses during prolonged exercise in the heat.