Feasibility Study of an Educational Intervention to Improve Water Intake in Adolescent Soccer Players: A Two-Arm, Non-Randomized Controlled Cluster Trial

A questionnaire study on the knowledge, attitudes, and practices of fluid replacement and urination among Chinese elite athletes

OBJECTIVE

To evaluate the knowledge, attitudes and practices (KAP) of Chinese elite athletes about fluid replacement and urination.

METHODS

A cross-section study was carried out among Chinese national and national youth teams from March to April 2020, using a pretested questionnaire. The 42-questions questionnaire was designed to assess the KAP regarding fluid replacement and urination. The questionnaire included knowledge of fluid replacement (KFR), attitudes of fluid replacement (AFR), knowledge of urination (KU), and attitudes of urination (AU), which were awarded 20 scoring points. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson's correlation analysis, Multiple linear stepwise regression and Chi-square test were performed.

RESULTS

A total of 779 valid questionnaires were collected and the effective rate is 98.4%. We finally conducted an assessment of 646 questionnaires of elite athletes. The mean score for KFR, AFR, KU, and AU was 2.8±1.3, 2.3±0.6, 3.0±1.5, and 2.1±0.8, respectively, with higher scores indicating positive hydration knowledge and attitudes. KFR and AFR scores of winter sports athletes were higher than those of summer sports athletes(P<0.05). Athletes who had lower athletic grades and training years had a worse KFR(P<0.05). Only 31.0% athletes knew that rehydration should be carried out before, during, and after training, which was scarcer among women, lower-athletic grades athletes, or athletes with lower training years (P<0.05). Male athletes had a worse KU but a better AU than female athletes(P<0.05). And athletes who were international-class athletic grades had the highest KU scores(P<0.05). The athletic grades and sport events were the main factors influencing the total scores of knowledge and attitudes (P<0.05, 95% CI -0.789--0.168,95% CI 0.025-1.040). Most of athletes tend to get hydration knowledge from internet. In practices, thirst is the main reason for rehydration (77.9%). The percentages of athletes with normal urine color (42.0%), frequency (75.0%,) and volume (20.0%) were low.

CONCLUSIONS

These findings indicate that Chinese elite athletes did not have sufficient KAP on fluid replacement and urination, more marked in the individuals who were summer sport events, the lower athletic grades and in lower training years. It is recommended that education should be provided in the early stages of professional training for athletes.

Improving hydration in elite male footballers during a national team training camp – an observational case study

[Purpose] The purpose of this study was to (i) assess hydration levels in elite male football players during a national team training camp before and during qualifying matches, (ii) evaluate the effect of coaching strategies for hydration based on feedback from hydration monitoring, and (iii) assess possible relationships between hydration status and training load or wellness markers.[Methods] Thirty-one male players (age 27±4 yrs; height 185±6 cm; weight 82.9±6.7 kg; body fat 10.4±2.3%) representing a national team from the Union of European Football Associations (UEFA) participated. The players were studied during three different national team training camps related to the UEFA Nations League tournament. Urine specific gravity (USG) was measured to assess hydration status. During all camps, the players were actively coached on improving strategies for hydration and given individual feedback on their test results. The training load was measured using GPS technology, and wellness questionnaires were completed.[Results] USG decreased progressively and significantly (p<0.005) during camp 1 and hydration status improved over the three camps, with fewer dehydrated and more well-hydrated players identified during the last part of camp 3. Significantly (p<0.05) higher USG values were observed 2 days prior to a match (MD-2) than on match day (MD); consequently, 52% of the players were dehydrated on MD-2 and only 6% on MD. No correlations were observed between hydration status and training load or wellness markers.[Conclusion] Dehydration is a challenge in elite male football, but continuous monitoring of hydration status and coaching on hydration strategies can lead to major improvements and reduce the degree of dehydration.