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Wu B, Guo Y, Min S, Xiong Q, Zou L. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy. Open Med (Wars) 2024; 19:20240930. [PMID: 38584828 PMCID: PMC10997005 DOI: 10.1515/med-2024-0930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 04/09/2024] Open
Abstract
To investigate the impact of goal-directed fluid therapy (GDFT) on postoperative cognitive dysfunction (POCD) in elderly patients with colorectal cancer, we conducted a randomized controlled trial. Eighty elderly patients who underwent elective laparoscopic radical resection of colorectal cancer were randomly assigned to either the GDFT group or the conventional fluid therapy group. The primary outcome was the incidence of POCD during the initial 7 postoperative days, while secondary outcomes included inflammatory marker levels such as interleukin-6 (IL-6) and S100β protein, hemodynamics, level of lactic acid, postoperative functional recovery, and complications. Among 88 randomized patients, 80 were evaluable for the primary outcome. The incidence of POCD was significantly lower in the GDFT group (15.0%) compared to the conventional fluid therapy group (30.0%), with the highest occurrence observed on day 3 postoperatively in both groups (P < 0.05). IL-6 and S100β concentrations were consistently lower in the GDFT group than in the conventional fluid therapy group at the corresponding time points (P < 0.05). The GDFT group exhibited more stable perioperative hemodynamics and lower lactate levels (P < 0.05). Moreover, patients in the GDFT group exhibited better postoperative functional recovery indicators and a lower incidence of postoperative complications (P < 0.05). In summary, GDFT appears to reduce the incidence of early POCD, accelerate postoperative recovery, and enhance overall prognosis.
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Affiliation(s)
- Bin Wu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
| | - Yuanyuan Guo
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1#, Yuzhong District, Chongqing 400016, People’s Republic of China
| | - Qiuju Xiong
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
| | - Lei Zou
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
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Lee JW, Kim Y. Association of plain water intake with self-reported depression and suicidality among Korean adolescents. Epidemiol Health 2024; 46:e2024019. [PMID: 38271962 PMCID: PMC11099597 DOI: 10.4178/epih.e2024019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES Adolescent depression and suicidality are serious health problems worldwide. Lower plain water intake has been proposed as a risk factor for depression in adults. This study investigated the association of daily plain water intake with self-reported depression and suicidality among Korean adolescents. METHODS We used nationwide data from 112,250 students aged 12-18 years who participated in the Korean Youth Risk Behavior Web-based Surveys in 2019 and 2020. Daily plain water intake was categorized as <1 glass, 1-2 glasses, and ≥3 glasses. The adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for self-reported depression and suicidality were calculated using multiple regression analyses. RESULTS The weighted prevalence rates of self-reported depression, suicidal ideation, suicide planning, and suicide attempts were 26.7%, 12.0%, 3.8%, and 2.5%, respectively. Of the participants, 3.9%, 18.5%, and 77.7% were categorized into the <1 glass/day, 1-2 glass/day, and ≥3 glass/day groups, respectively. Compared to the reference group (≥3 glass/day), the lowest level of water intake (<1 glass/day) was associated with higher odds of self-reported depression (aOR, 1.30; 95% CI, 1.20 to 1.39), suicidal ideation (aOR, 1.39; 95% CI, 1.27 to 1.55), suicide planning (aOR, 1.46; 95% CI, 1.25 to 1.69), and suicide attempts (aOR, 1.38; 95% CI, 1.15 to 1.67). Moderately lower water intake (1-2 glass/day) showed slightly increased odds of self-reported depression (aOR, 1.05; 95% CI, 1.01 to 1.10) and suicidal ideation (aOR, 1.08; 95% CI, 1.03 to 1.14). CONCLUSIONS Lower plain water intake was significantly associated with a higher risk of self-reported depression and suicidality among Korean adolescents. Since this cross-sectional study is unable to establish a causal relationship, it underscores the need for additional longitudinal research.
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Affiliation(s)
- Jung Woo Lee
- BK21 Four Research & Education Center for Sustainable Living System, Korea University, Seoul, Korea
| | - Yookyung Kim
- Department of Home Economics Education, Korea University College of Education, Seoul, Korea
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Hydration and Cognitive Task Performance in Children: A Systematic Review. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00249-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Renal transcriptome profiles in mice reveal the need for sufficient water intake irrespective of the drinking water type. Sci Rep 2022; 12:10911. [PMID: 35764881 PMCID: PMC9240086 DOI: 10.1038/s41598-022-14815-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/13/2022] [Indexed: 12/05/2022] Open
Abstract
This study sought to characterize the impact of long-term dehydration in terms of physiological and biochemical parameters, as well as renal transcriptomes. Furthermore, we assessed whether consumption of specific types of water elicit more beneficial effects on these health parameters. To this end, C57BL/6 mice were either provided water for 15 min/day over 2 and 4 weeks (water restricted; RES), or ad libitum access to distilled (CON), tap, spring, or purified water. Results show that water restriction decreases urine output and hematocrit levels while increasing brain vasopressin mRNA levels in RES mice compared to control mice (CON). Meanwhile, blood urea nitrogen and creatinine levels were higher in the RES group compared to the CON group. Kidney transcriptome analysis further identified kidney damage as the most significant biological process modulated by dehydration. Mechanistically, prolonged dehydration induces kidney damage by suppressing the NRF2-signaling pathway, which targets the cytoprotective defense system. However, type of drinking water does not appear to impact physiological or blood biochemical parameters, nor the renal transcriptome profile, suggesting that sufficient water consumption is critical, irrespective of the water type. Importantly, these findings also inform practical action for environmental sustainability by providing a theoretical basis for reducing bottled water consumption.
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Rauf S, Achmad I, Lestaluhu SA. WATER SUPPLEMENTATION AFFECTS THE FLUID INTAKE AND SERUM LEVELS OF BDNF AMONG THE ELDERLY IN NURSING HOME. Nutrition 2022; 101:111700. [DOI: 10.1016/j.nut.2022.111700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/29/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Vieira GR, Leôncio LMDL, Bezerra CG, David MCMM, Matos RJBD. Is there a functional relationship between hydration and memory in children and adolescents? A meta-analysis. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i2.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: Hydration can favor cognitive functions during childhood and adolescence, helping with daily and school activities. This study aimed to identify possible interactions between hydration and memory in children and adolescents. Methods: This is a systematic review with meta-analysis. The bibliographic search was conducted in the MEDLINE/PubMed, SciELO, LILACS, Web of Science, Embase, and Cochrane Library databases, through a combination of the descriptors: “hydration” AND “memory”; “hydration” AND “memory” AND “child”; “hydration” AND “memory” AND “children”; “organism hydration status” AND “memory”; “organism hydration status” AND “memory” AND “child”. Results: The search resulted in 816 articles, of which ten were selected for qualitative synthesis and two for the meta-analysis. The results indicated that hydration could not enhance working, visual and visuomotor memories, or visual attention (Line Tracing Task, MD 0.67, 95% CI -0.87 to 2.22; Indirect Image Difference, MD 0.32, 95% CI -0.75 to 1.40; Letter Cancellation, MD 1.68, 95% CI -0.81 to 4.17). Conclusion: From the obtained results, hydration per se does not reinforce working, visual and visuomotor memories, or visual attention. However, there are still gaps regarding other types of memory and cognitive, motor, nutritional and environmental integration.
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Dehydration in older people: A systematic review of the effects of dehydration on health outcomes, healthcare costs and cognitive performance. Arch Gerontol Geriatr 2021; 95:104380. [PMID: 33636649 DOI: 10.1016/j.archger.2021.104380] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/27/2021] [Accepted: 02/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To systematically examine the effect of dehydration on health outcomes, identify associated financial costs and consider impacts on cognitive performance in older adults. DESIGN A systematic review of English-language articles via OVID using MEDLINE, PsychINFO, EMBASE, and others, to March 2018. Included studies examined the relationship between hydration status and health, care costs or cognitive outcome. SETTING Cross sectional and cohort data from studies reporting on dehydration in older adults. PARTICIPANTS Adults aged 60 years and older. MEASUREMENTS Independent quality ratings were assessed for all extracted articles. RESULTS Of 1684 articles screened, 18 papers (N = 33,707) met inclusion criteria. Participants were recruited from hospital settings, medical long-term care centres and the community dwelling population. Data were synthesised using a narrative summary. Mortality rates were higher in dehydrated patients. Furthermore, health outcomes, including frailty, bradyarrhythmia, transient ischemic attacks, oral health and surgery recovery are linked to and worsened by dehydration. Length of hospital stay, either as a principal or secondary diagnosis, is greater in those with dehydration, compared to those who are euhydrated. Finally, neurocognitive functioning may be impacted by dehydration. There are issues with study design, inconsistency in hydration status measurement and different measures used for outcome assessment. CONCLUSION Dehydration in older people is associated with increased mortality, poorer course of illness and increased costs for health services. In addition, there is some, but sparse evidence that dehydration in older people is linked to poorer cognitive performance. Intervention studies should test strategies for reducing dehydration in older adults.
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Hu F, Yang J, Li P, Qiu W, Hou X, Wei X, Wang H, Kauffman AE, Xiao S, Liao Z, Kimura SY, Zheng W, Lin J, Zhu S. Is direct-drinking water safe for children? An analysis of direct-drinking water quality and its risk factors in Shanghai elementary and middle schools. Int J Hyg Environ Health 2020; 231:113650. [PMID: 33152617 DOI: 10.1016/j.ijheh.2020.113650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/09/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Drinking water quality for children should be higher than adults due to both behavioral and physiological factors. Thus, to provide enough, safe, and easily accessible drinking water for children at schools, the Shanghai Municipal Government initiated a direct-drinking water project in 2013. However, there has been no study so far to assess the quality of direct-drinking water or to investigate its risk factors in Shanghai elementary and middle schools. METHODS In the present study, we selected direct-drinking water equipment from 183 elementary and middle schools (17% of total) in Shanghai to detect the colony-forming units (CFU), residual chlorine, chemical oxygen demand (COD), and turbidity of water samples, and analyzed the risk factors of its quality using both simple and multiple linear regression analysis. RESULTS Results showed that the CFU, residual chlorine, COD, and turbidity of direct-drinking water in Shanghai elementary and middle schools ranged from <LOD->300 cfu/mL, <LOD-0.670 mg/L, 0.090-2.710 mg/L, and 0.100-2.050 NTU, respectively. The results of simple linear regression analysis indicated that the CFU of direct-drinking water significantly increased when water temperature was between 25 and 60 °C (β = 19.862, p = 0.030), but it was decreased at 60-100 °C (β = - 16.387, p = 0.046). Additionally, the CFU was higher in elementary schools than middle schools, which was also affected by faucet type and water treatment technology (p = 0.006, 0.012 and 0.042, respectively). The residual chlorine in direct-drinking water significantly increased when there was no toilet within 10 m (β = 0.012, p = 0.045). The COD of direct-drinking water was significantly higher in rural areas and in warm water, compared to urban areas (p = 0.033) and room temperature water (p = 0.000), respectively. The turbidity of direct-drinking water was significantly higher in urban areas and water using UF/MF technology, compared to rural areas (p = 0.030) and RO technology (p = 0.009), respectively. The results of multiple linear regressions analysis drew the same conclusions. CONCLUSIONS In order to improve the quality of direct-drinking water, the equipment should be as far away from toilet as possible and direct-drinking water should be kept at room temperature or heated at high temperature (over 60 °C). Furthermore, sanitary standards of direct-drinking water quality and relevant laws and regulations should be established and implemented as soon as possible. Our study demonstrates that it is critical to improve direct-drinking water quality and ensure the safety of drinking water in elementary and middle schools in Shanghai.
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Affiliation(s)
- Fen Hu
- Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200032, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, 200032, China
| | - Jianping Yang
- Inspecting Agency, Shanghai Municipal Health Commission, Inspecting Agency, Shanghai Municipal Health Commission, Shanghai, 200031, China
| | - Ping Li
- Inspecting Agency, Shanghai Municipal Health Commission, Inspecting Agency, Shanghai Municipal Health Commission, Shanghai, 200031, China
| | - Wei Qiu
- Inspecting Agency, Shanghai Municipal Health Commission, Inspecting Agency, Shanghai Municipal Health Commission, Shanghai, 200031, China
| | - Xinyun Hou
- Minhang High School, Shanghai, 200240, China
| | - Xiao Wei
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China
| | - Haiyin Wang
- Department of Health Technology Assessment, Shanghai Health Development Research Center, Shanghai, 200032, China
| | - Alexandra E Kauffman
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Shuo Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, 08854, USA
| | - Zhiwei Liao
- Department of General Surgery, Renhe Hospital, Shanghai, 200431, China
| | - Susana Y Kimura
- University of Calgary, Calgary, Department of Chemistry, AB T2N 1N4, Canada.
| | - Weiwei Zheng
- Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200032, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, 200032, China; Center for Water and Health, Fudan University, Shanghai, 200032, China.
| | - Jianhai Lin
- Inspecting Agency, Shanghai Municipal Health Commission, Inspecting Agency, Shanghai Municipal Health Commission, Shanghai, 200031, China.
| | - Surong Zhu
- Inspecting Agency, Shanghai Municipal Health Commission, Inspecting Agency, Shanghai Municipal Health Commission, Shanghai, 200031, China.
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Ogum-Alangea D, Aryeetey RNO, Gray HL, Laar AK, Adanu RMK. Basic school pupils' food purchases during mid-morning break in urban Ghanaian schools. PLoS One 2020; 15:e0238308. [PMID: 32870945 PMCID: PMC7462272 DOI: 10.1371/journal.pone.0238308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 08/13/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Unhealthy food vending can expose children to malnutrition and other diet related challenges such as obesity. This study sought to describe types and sources of food in basic schools in urban Accra, and to describe food purchases by pupils. METHODS This was a cross-sectional study of five basic schools (3 public; 2 private) and 644 pupils in the Ga-East Municipality in Ghana. Check-lists were used to document available sources of foods during school hours. Pupils were intercepted after making purchases during breaktime and the type, cost and sources of foods purchased documented. Energy content of foods were read from labels when available or estimated using the Ghana Food Composition database when unlabelled. Frequencies and crosstabs were used to compare food type by source and school type. RESULTS Foods were purchased from school canteen, school store, private stores, and 'table-top' vendors. Meals were most frequently purchased (38%) although single purchases were sweetened drinks, savoury snacks and confectioneries. About 53% of retailers located within the schools sold relatively healthier food options. Similar foods with comparable energy content were purchased within and outside of school. CONCLUSIONS Basic schools in urban Ghana provide ready access to energy dense food options, which are purchased by pupils both within and outside of school premises. Timely interventions inclusive of school food policies can encourage healthier diets among pupils.
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Affiliation(s)
- Deda Ogum-Alangea
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Legon, Ghana
| | - Richmond N. O. Aryeetey
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Legon, Ghana
| | - Heewon L. Gray
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Amos K. Laar
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Legon, Ghana
| | - Richard M. K. Adanu
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Legon, Ghana
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Khan NA, Westfall DR, Jones AR, Sinn MA, Bottin JH, Perrier ET, Hillman CH. A 4-d Water Intake Intervention Increases Hydration and Cognitive Flexibility among Preadolescent Children. J Nutr 2019; 149:2255-2264. [PMID: 31504690 DOI: 10.1093/jn/nxz206] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/10/2019] [Accepted: 07/26/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Hydration effects on cognition remain understudied in children. This is concerning since a large proportion of US children exhibit insufficient hydration. OBJECTIVE This study investigated the effects of water intake on urinary markers of hydration and cognition among preadolescents. METHODS A 3-intervention crossover design was used among 9- to 11-y-olds [n = 75 (43 males, 32 females); 58.2 ± 28.5 BMI percentile]. Participants maintained their water intake [ad libitum (AL)] or consumed high (2.5 L/d) or low (0.5 L/d) water for 4 d. The primary outcomes were performance on cognitive tasks requiring inhibition, working memory, and cognitive flexibility assessed using a modified flanker, go/no-go, and color-shape switch tasks, respectively. Secondary outcomes included urine hydration indices [i.e., color, urine specific gravity (USG), osmolality] assessed using 24-h urine collected during day 4 of each intervention. Repeated-measures ANOVAs were used to assess intervention effects. RESULTS There was a significant difference in hydration across all 3 interventions. Urine color during the low intervention [median (IQR): 6 (2)] was greater than during AL [5 (2)], and both were greater than during the high intervention [18 (0)] (all P ≤ 0.01). Similarly, osmolality [low (mean ± SD): 912 ± 199 mOsmol/kg, AL: 790 ± 257.0 mOsmol/kg, high: 260 ± 115 mOsmol/kg] and USG [low (mean ± SD): 1.023 ± 0.005, AL: 1.020 ± 0.007, high: 1.005 ± 0.004] during the low intervention were greater during AL, and both were greater than during the high intervention (all P ≤ 0.01). USG and osmolality AL values were related to switch task measures (β: 0.21 to -0.31, P < 0.05). Benefits of the high intervention were observed during the switch task, whereby participants exhibited 34% lower working memory cost relative to the low intervention. No significant changes in cognition were observed for the flanker and go/no-go tasks. CONCLUSIONS The water intervention improved urinary markers of hydration and had selective benefits during task switching. Furthermore, children's cognitive flexibility selectively benefits from greater habitual hydration and water intake. This study is registered at clinicaltrials.gov as NCT02816450.
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Affiliation(s)
- Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA.,Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA.,Neuroscience Program, University of Illinois, Urbana, IL, USA
| | | | - Alicia R Jones
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - Macie A Sinn
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA
| | - Jeanne H Bottin
- Health, Hydration, and Nutrition Science Department, Danone Research, Palaiseau, France
| | - Erica T Perrier
- Health, Hydration, and Nutrition Science Department, Danone Research, Palaiseau, France
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA.,Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
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Demographic and Lifestyle Factors and Memory in European Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234727. [PMID: 31783491 PMCID: PMC6926502 DOI: 10.3390/ijerph16234727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 11/25/2022]
Abstract
Objectives: To investigate associations between demographic and lifestyle factors and memory performance in European people aged ≥60 years. Methods: Data from 23,641 people with a mean age of 70.2 (95 % CI 70.1–70.3) were analyzed and drawn from the fourth wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Generalized linear models were carried out to estimate the associations for both men and women. Memory performance was tested using two word-list learning tests with immediate and delayed recall in SHARE. Results: age, severe limitations in physical activities, and any past alcohol problem were all negatively associated with memory performance. Contrarily, education level, higher nonalcoholic fluid intake, and engagement in sports activities more than once a week and in activities requiring a moderate level of energy were all positively associated with memory performance. Smoking showed a significant negative association only in the immediate recall test for both men and women together, whilst long-term illness showed association only in the delayed recall. Alcohol consumption was positively associated with memory performance in women, but in men, it depended on the drinking frequency. Conclusions: Demographic and lifestyle factors are associated with memory performance in the older population.
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Cognitive performance in relation to hydration status and water intake among older adults, NHANES 2011–2014. Eur J Nutr 2019; 59:3133-3148. [DOI: 10.1007/s00394-019-02152-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 11/20/2019] [Indexed: 12/14/2022]
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Autonomic adaptations mediate the effect of hydration on brain functioning and mood: Evidence from two randomized controlled trials. Sci Rep 2019; 9:16412. [PMID: 31712590 PMCID: PMC6848126 DOI: 10.1038/s41598-019-52775-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/23/2019] [Indexed: 12/30/2022] Open
Abstract
Dehydration (water loss >2.0% of body weight) has significant negative effects on physical and mental performance. In two studies the effects of minor hypo-hydration (water loss <1.0% of body weight) on CNS function, mood and cardiovascular functioning were measured. Study 1: On two mornings twelve male participants were exposed to a temperature of 30 °C for four hours and either did or did not drink two 150 ml glasses of water during that time. Study 2: Fifty-six (25 M) individuals were exposed to the same 30 °C environment and randomly allocated to either drink (2 × 150 ml) or not drink. When not given water 0.59% (Study 1) and 0.55% (Study 2) bodyweight was lost. Participant’s heart rate variability (HRV) was measured, and they rated their thirst and mood. In study 1, participants participated in an fMRI protocol during which they completed a modified version of the Paced Auditory Serial Addition Test (PASAT), at the end of which they rated its difficulty. Decreases in fMRI BOLD activity in the orbito-frontal cortex, ventral cingulate gyrus, dorsal cingulate cortex, hypothalamus, amygdala, right striatum, post-central gyrus and superior parietal cortex were observed when participants were hypo-hydrated. These deactivations were associated with reduced HRV, greater perceived effort, and more anxiety. In study 2 declines in HRV were found to mediate the effect of hypo-hydration on ratings of anxiety. These data are discussed in relation to a model that describes how autonomic regulatory and interoceptive processes may contribute to the affective consequences of minor hypo-hydration.
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Cousins AL, Young HA, Thomas AG, Benton D. The Effect of Hypo-Hydration on Mood and Cognition Is Influenced by Electrolyte in a Drink and Its Colour: A Randomised Trial. Nutrients 2019; 11:E2002. [PMID: 31450591 PMCID: PMC6769552 DOI: 10.3390/nu11092002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 02/03/2023] Open
Abstract
Traditionally, it has been thought necessary to lose 2% of body mass due to dehydration to disrupt functioning, although recently, adverse effects have been reported, with a loss of 0.5%-0.7%. It is, however, unclear whether the response to small reductions in mass reflects dehydration as homeostatic mechanisms are thought to be effective. As psychological responses are most commonly reported, it is strange that the possibility of a placebo response has not been considered. Individuals were therefore subject to a temperature of 30 °C for three hours, and mood and cognition were monitored. To consider changes in hydration status, drinks were compared, differing in their ability to rehydrate due to the presence or absence of electrolytes. The possibility of a placebo response was considered by comparing the response to plain or coloured water. Not drinking was disruptive, although a combination of plain water and electrolyte tended to be the most effective means of preventing a decline in mood, indicating a role for rehydration after a loss of 0.66% body mass. There was, however, also evidence of a placebo response: a combination of plain water and electrolyte tended to be better able to prevent a decline in mood than coloured water and electrolyte.
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Affiliation(s)
- Alecia L Cousins
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK
| | - Hayley A Young
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK
| | - Andrew G Thomas
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK
| | - David Benton
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK.
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Pierce HM, Perry L, Gallagher R, Chiarelli P. Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives. J Adv Nurs 2019; 75:2579-2590. [PMID: 31236988 DOI: 10.1111/jan.14128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/07/2019] [Accepted: 06/04/2019] [Indexed: 11/28/2022]
Abstract
AIM To examine the relationships between workplace bladder practices, urinary symptoms, and work productivity. DESIGN Cross-sectional observational survey. METHODS Surveys were distributed June-November 2016 to at least 600 female nurses and midwives at three urban hospitals in New South Wales, Australia. Nurses self-reported restricted workplace access to toilets, delaying voiding, limiting of fluid intakes and urinary symptoms at work. Logistic modelling was used to examine whether nurses' bladder practices impaired their time management, ability to concentrate or perform physical demands. RESULTS Of 353 useable surveys, one in five nurses (22.4%; N = 79) reported restricted access to toilets at work, most (77.1%; N = 272) delayed voiding and one in four (26.9%; N = 95) limited fluid intakes to delay voiding at work. Almost half the sample had urinary symptoms at work (46.7%; N = 165); delaying voiding increased the likelihood of impaired mental concentration and limiting fluid intakes increased the likelihood of impaired time management. CONCLUSION As workplace access to toilets and related bladder practices are modifiable, associated urinary symptoms and productivity loss may be preventable. IMPACT Nurses' often experience restricted accesses to amenities due to job demands and workplace environments. The impact of nurses' poor bladder practices in the workplace is not known. In this study most nurses delayed voiding and many purposefully limited fluid intakes at work. These behaviours impacted a nurse's ability to manage time and/or concentrate at work. Results have implications for nurses' personal health, the design of workplace environments, workforce management, occupational health policy, and patient care.
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Affiliation(s)
- Heather M Pierce
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Sydney, Australia.,Prince of Wales Hospital, Sydney Hospital and Sydney Eye Hospital, Randwick, Australia
| | - Robyn Gallagher
- Charles Perkins Centre, Sydney School of Nursing, University of Sydney, Sydney, Australia
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Merhej R. Dehydration and cognition: an understated relation. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2019. [DOI: 10.1108/ijhg-10-2018-0056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rita Merhej
- Department of Psychology, Faculty of Social and Behavioral Sciences, Haigazian University, Beirut, Lebanon
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17
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Patsalos OC, Thoma V. Water supplementation after dehydration improves judgment and decision-making performance. PSYCHOLOGICAL RESEARCH 2019; 84:1223-1234. [PMID: 30666412 PMCID: PMC7271046 DOI: 10.1007/s00426-018-1136-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/10/2018] [Indexed: 11/28/2022]
Abstract
Previous research has shown that dehydration and water supplementation affect mood and cognitive performance in both adults and children on a variety of tasks that assess memory, attention, executive function, and speeded responses. Given the varied effects of water on cognition, this study explored potential effects of water supplementation, hydration status, and thirst on thinking and decision-making tasks. 29 adult participants undertook a battery of cognitive tests on two separate occasions after having fasted from the previous night. On one occasion, they were offered 500 ml of water to drink prior to testing. Measures of urine osmolality confirmed the group-level effectiveness of the dehydration manipulation. Water supplementation was found to improve performance on tasks measuring cognitive reflection in judgement and decision-making. This increase in performance was associated with differences in tasks implicated in inhibition processes. Drinking water after a 12-h dehydration period increased performance in judgement and decision-making tasks, and this was not explained by differences in subjective thirst or attentiveness.
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Affiliation(s)
- Olivia C Patsalos
- Section of Eating Disorders, Department of Psychological Medicine, King's College London, London, SE5 8AZ, UK.
| | - Volker Thoma
- University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
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Piil JF, Lundbye-Jensen J, Christiansen L, Ioannou L, Tsoutsoubi L, Dallas CN, Mantzios K, Flouris AD, Nybo L. High prevalence of hypohydration in occupations with heat stress-Perspectives for performance in combined cognitive and motor tasks. PLoS One 2018; 13:e0205321. [PMID: 30356308 PMCID: PMC6200230 DOI: 10.1371/journal.pone.0205321] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/24/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To evaluate the prevalence of dehydration in occupational settings and contextualize findings to effects on performance in cognitively dominated tasks, simple and complex motor tasks during moderate and high heat stress. Methods The study included an occupational part with hydration assessed in five industries across Europe with urine samples collected from 139 workers and analyzed for urine specific gravity. In addition, laboratory experiments included eight male participants completing mild-intensity exercise once with full fluid replacement to maintain euhydration, and once with restricted water intake until the dehydration level corresponded to 2% bodyweight deficit. Following familiarization, euhydration and dehydration sessions were completed on separate days in random order (cross-over design) with assessment of simple motor (target pinch), complex motor (visuo-motor tracking), cognitive (math addition) and combined motor-cognitive (math and pinch) performance at baseline, at 1°C (MOD) and 2°C (HYPER) delta increase in body core temperature. Results The field studies revealed that 70% of all workers had urine specific gravity values ≥1.020 corresponding to the urine specific gravity (1.020±0.001) at the end of the laboratory dehydration session. At this hydration level, HYPER was associated with reductions in simple motor task performance by 4±1%, math task by 4±1%, math and pinch by 9±3% and visuo-motor tracking by 16±4% (all P<0.05 compared to baseline), whereas no significant changes were observed when the heat stress was MOD (P>0.05). In the euhydration session, HYPER reduced complex (tracking) motor performance by 10±3% and simple pinch by 3±1% (both P<0.05, compared to baseline), while performance in the two cognitively dominated tasks were unaffected when dehydration was prevented (P>0.05). Conclusion Dehydration at levels commonly observed across a range of occupational settings with environmental heat stress aggravates the impact of hyperthermia on performance in tasks relying on combinations of cognitive function and motor response accuracy.
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Affiliation(s)
- Jacob F. Piil
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Jesper Lundbye-Jensen
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Christiansen
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Leonidas Ioannou
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Lydia Tsoutsoubi
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Constantinos N. Dallas
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Konstantinos Mantzios
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
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Gandy J, Martinez H, Carmuega E, Arredondo JL, Pimentel C, Moreno LA, Kavouras SA, Salas-Salvadó J. Fluid intake of Latin American children and adolescents: results of four 2016 LIQ.IN 7 National Cross-Sectional Surveys. Eur J Nutr 2018; 57:53-63. [PMID: 29858628 PMCID: PMC6008370 DOI: 10.1007/s00394-018-1728-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/22/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE The primary aim of this survey was to report total fluid intake (TFI) and different fluid types for children (4-9 years) and adolescents (10-17 years) in Mexico, Brazil, Argentina and Uruguay. The second aim was to compare TFI with the adequate intake (AI) of water from fluids as recommended by the USA Institute of Medicine. METHODS Data were collected using a validated liquid intake 7-day record (Liq.In 7 ). Participants' characteristics, including age, sex and anthropometric measurements were recorded. RESULTS A total of 733 children and 933 adolescents were recruited. Over 75% of children in Uruguay met the IOM's recommended intake. Fewer children in Argentina (64-72%) and Brazil (41-50%) obtained AI and the lowest values were recorded in Mexico (33-44%), where 16% of boys and 14% girls drank 50% or less of the AI. More adolescents in Argentina (42%) met the AIs than other countries; the lowest was in Mexico (28%). Children and adolescents in Mexico and Argentina drank more sugar sweetened beverages than water. CONCLUSIONS Large numbers of children and adolescents did not meet AI recommendations for TFI, raising concerns about their hydration status and potential effects on mental and physical well-being. Given the negative effects on children's health, the levels of SSB consumption are worrying.
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Affiliation(s)
- J Gandy
- British Dietetic Association, Birmingham, UK.
- School of Life and Medical Services, University of Hertfordshire, Hatfield, AL10 9AB, UK.
| | - H Martinez
- Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - E Carmuega
- Center of Studies on Infant Nutrition, Buenos Aires, Argentina
| | - J L Arredondo
- Unidad de Apoyo a la Investigación Clínica, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - C Pimentel
- Unidad de Apoyo a la Investigación Clínica, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - L A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- CIBERobn (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición), Institute of Health Carlos III, Madrid, Spain
| | - S A Kavouras
- Hydration Science Lab, University of Arkansas, Fayetteville, AR, USA
- Division of Endocrinology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Salas-Salvadó
- CIBERobn (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición), Institute of Health Carlos III, Madrid, Spain
- Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, C/Sant Llorenç, 21, 43201, Reus, Spain
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20
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Engelheart S, Brummer R. Assessment of nutritional status in the elderly: a proposed function-driven model. Food Nutr Res 2018; 62:1366. [PMID: 29720931 PMCID: PMC5917421 DOI: 10.29219/fnr.v62.1366] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 01/04/2023] Open
Abstract
Background There is no accepted or standardized definition of ‘malnutrition’. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness. Objective We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people. Design and results The presented model could be interpreted as the nutritional status is conditional to a person’s optimal function or situation. Another way of looking at it might be that a person’s nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain. Conclusions Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.
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Affiliation(s)
| | - Robert Brummer
- School of Medical Sciences, Örebro University, Örebro, Sweden
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22
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McCartney D, Desbrow B, Irwin C. The Effect of Fluid Intake Following Dehydration on Subsequent Athletic and Cognitive Performance: a Systematic Review and Meta-analysis. SPORTS MEDICINE-OPEN 2017; 3:13. [PMID: 28316054 PMCID: PMC5357466 DOI: 10.1186/s40798-017-0079-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/28/2017] [Indexed: 01/08/2023]
Abstract
Background The deleterious effects of dehydration on athletic and cognitive performance have been well documented. As such, dehydrated individuals are advised to consume fluid in volumes equivalent to 1.25 to 1.5 L kg−1 body mass (BM) lost to restore body water content. However, individuals undertaking subsequent activity may have limited time to consume fluid. Within this context, the impact of fluid intake practices is unclear. This systematic review investigated the effect of fluid consumption following a period of dehydration on subsequent athletic and cognitive performance. Methods PubMed (MEDLINE), Web of Science (via Thomas Reuters) and Scopus databases were searched for articles reporting on athletic (categorized as: continuous, intermittent, resistance, sport-specific and balance exercise) or cognitive performance following dehydration of participants under control (no fluid) and intervention (fluid intake) conditions. Meta-analytic procedures determined intervention efficacy for continuous exercise performance. Results Sixty-four trials (n = 643 participants) derived from 42 publications were reviewed. Dehydration decreased BM by 1.3–4.2%, and fluid intake was equivalent to 0.4–1.55 L kg−1 BM lost. Fluid intake significantly improved continuous exercise performance (22 trials), Hedges’ g = 0.46, 95% CI 0.32, 0.61. Improvement was greatest when exercise was performed in hotter environments and over longer durations. The volume or timing of fluid consumption did not influence the magnitude of this effect. Evidence indicating a benefit of fluid intake on intermittent (10 trials), resistance (9 trials), sport-specific (6 trials) and balance (2 trials) exercise and on cognitive performance (15 trials) was less apparent and requires further elucidation. Conclusions Fluid consumption following dehydration may improve continuous exercise performance under heat stress conditions, even when the body water deficit is modest and fluid intake is inadequate for complete rehydration. Electronic supplementary material The online version of this article (doi:10.1186/s40798-017-0079-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danielle McCartney
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Ben Desbrow
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Christopher Irwin
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Irwin C, Campagnolo N, Iudakhina E, Cox GR, Desbrow B. Effects of acute exercise, dehydration and rehydration on cognitive function in well-trained athletes. J Sports Sci 2017; 36:247-255. [DOI: 10.1080/02640414.2017.1298828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Christopher Irwin
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Nadia Campagnolo
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Elizaveta Iudakhina
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Gregory R. Cox
- Sports Nutrition, Australian Institute of Sport, Gold Coast, Queensland, Australia
| | - Ben Desbrow
- Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
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Benton D, Jenkins KT, Watkins HT, Young HA. Minor degree of hypohydration adversely influences cognition: a mediator analysis. Am J Clin Nutr 2016; 104:603-12. [PMID: 27510536 DOI: 10.3945/ajcn.116.132605] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/20/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Because the assumption that small changes in hydration status are readily compensated by homeostatic mechanisms has been little studied, the influence of hypohydration on cognition was examined. OBJECTIVES We assessed whether a loss of <1% of body mass due to hypohydration adversely influenced cognition, and examined the possible underlying mechanisms. DESIGN A total of 101 individuals were subjected to a temperature of 30°C for 4 h and randomly either did or did not consume 300 mL H2O during that period. Changes in body mass, urine osmolality, body temperature, and thirst were monitored. Episodic memory, focused attention, mood, and the perceived difficulty of tasks were measured on 3 occasions. The data were analyzed with the use of a regression-based approach whereby we looked for variables that mediated the influence of hypohydration on psychological functioning. RESULTS Drinking water improved memory and focused attention. In the short-term, thirst was associated with poorer memory. Later, a greater loss of body mass was associated with poorer memory and attention (mean loss: 0.72%). At 90 min, an increase in thirst was associated with a decline in subjective energy and increased anxiety and depression, effects that were reduced by drinking water. At 180 min, subjects found the tests easier if they had consumed water. CONCLUSIONS Drinking water was shown, for the first time to our knowledge, to benefit cognitive functioning when there was a loss of <1% body mass at levels that may occur during everyday living. Establishing the variables that generate optimal fluid consumption will help to tailor individual advice, particularly in clinical situations. This trial was registered at clinicaltrials.gov as NCT02671149.
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Affiliation(s)
- David Benton
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | | | - Heather T Watkins
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Hayley A Young
- Department of Psychology, Swansea University, Swansea, United Kingdom
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Backes TP, Fitzgerald K. Fluid consumption, exercise, and cognitive performance. Biol Sport 2016; 33:291-6. [PMID: 27601785 PMCID: PMC4993146 DOI: 10.5604/20831862.1208485] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/16/2016] [Accepted: 06/18/2016] [Indexed: 11/13/2022] Open
Abstract
Laboratory evidence supports the notion that dehydration degrades exercise performance and impairs certain cognitive processes. The purpose of this study is to examine the effect of a voluntary versus a dictated drinking condition on exercise and cognitive performance. The study used a double-blind and paired design. Twenty male and female college students (10 women, 10 men) participated in an exercise protocol consisting of 1 hr of treadmill running followed by a high intensity portion continuing until voluntary exhaustion. The dictated drinking condition consisted of 900 ml of water equally distributed in 4 pre-prepared opaque bottles. At 15 min intervals the subject was instructed to drink the entire contents until the end of the 1 hr treadmill protocol. The voluntary drinking condition consisted of 225 ml of water within arm's reach of the subjects while on the treadmill. Exercise performance was significantly better (longer duration and faster speed) in the voluntary condition compared with the dictated condition. Cognitive test outcomes were not significantly different between drinking conditions. A difference in fluid absorption is a potential source of exercise impairment seen in the dictated fluid condition. The higher fluid consumption rate presumably would cause greater gastric and esophageal distention resulting in the diversion of blood flow from working muscles to the gastrointestinal system. In situations where dehydration is likely, drinking to recommended guidelines may protect individuals from dehydration and its negative effects. However, when dehydration is not likely, allowing an individual to follow voluntary drinking behavior is preferable for exercise performance.
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Affiliation(s)
- T P Backes
- Biology Department, State University of New York at Fredonia, Fredonia, NY 14063, USA
| | - K Fitzgerald
- Biology Department, State University of New York at Fredonia, Fredonia, NY 14063, USA
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26
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Fuchs T, Lührmann P, Simpson F, Dohnke B. Fluid Intake and Cognitive Performance: Should Schoolchildren Drink During Lessons? THE JOURNAL OF SCHOOL HEALTH 2016; 86:407-413. [PMID: 27122140 DOI: 10.1111/josh.12391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 09/30/2015] [Accepted: 01/09/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Evidence suggests that an insufficient fluid intake impairs cognitive performance. Drinking policies at schools-especially drinking during lessons-is a point of controversy. To provide a scientific base for this debate, more empirical evidence is needed on which aspects of fluid intake are crucial for cognitive performance. This study makes a contribution by investigating associations between quantitative and temporal aspects of fluid intake and cognitive performance in everyday school life. METHODS The study comprised 125 children (age: mean = 10.98 years, SD = 0.38). Amount of fluid intake and time span between fluid intake and completion of cognitive tests were determined on basis of self-reports. Cognitive performance was assessed by standardized tests. RESULTS Quantitative and temporal aspects were associated with cognitive performance: The more fluid the children consumed and the shorter the time span between their last fluid intake and test completion, the better they performed. CONCLUSIONS The amount of fluid intake should be adequate and moreover the time span between intake and cognitive efforts should be as short as possible. Schoolchildren are thus recommended to drink at regular intervals and also during lessons.
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Affiliation(s)
- Tanja Fuchs
- University of Education Schwäbisch Gmünd, Oberbettringer Str. 200, 73525 Schwäbisch Gmünd, Germany.
| | - Petra Lührmann
- University of Education Schwäbisch Gmünd, Oberbettringer Str. 200, 73525 Schwäbisch Gmünd, Germany.
| | - Faith Simpson
- University of Education Schwäbisch Gmünd, Oberbettringer Str. 200, 73525 Schwäbisch Gmünd, Germany.
| | - Birte Dohnke
- University of Education Schwäbisch Gmünd, Oberbettringer Str. 200, 73525 Schwäbisch Gmünd, Germany.
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Johnson EC, Muñoz CX, Jimenez L, Le Bellego L, Kupchak BR, Kraemer WJ, Casa DJ, Maresh CM, Armstrong LE. Hormonal and Thirst Modulated Maintenance of Fluid Balance in Young Women with Different Levels of Habitual Fluid Consumption. Nutrients 2016; 8:nu8050302. [PMID: 27213436 PMCID: PMC4882714 DOI: 10.3390/nu8050302] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/21/2016] [Accepted: 05/11/2016] [Indexed: 12/03/2022] Open
Abstract
Background: Surprisingly little is known about the physiological and perceptual differences of women who consume different volumes of water each day. The purposes of this investigation were to (a) analyze blood osmolality, arginine vasopressin (AVP), and aldosterone; (b) assess the responses of physiological, thirst, and hydration indices; and (c) compare the responses of individuals with high and low total water intake (TWI; HIGH and LOW, respectively) when consuming similar volumes of water each day and when their habitual total water intake was modified. Methods: In a single-blind controlled experiment, we measured the 24 h total water intake (TWI; water + beverages + food moisture) of 120 young women. Those who consumed the highest (HIGH, 3.2 ± 0.6 L·day−1, mean ± SD) and the lowest (LOW, 1.6 ± 0.5 L·day−1) mean habitual TWI were identified and compared. Outcome variables were measured during two ad libitum baseline days, a four-day intervention of either decreased TWI (HIGH) or increased TWI (LOW), and one ad libitum recovery day. Results: During the four-day intervention, HIGH and LOW experienced differences in thirst (p = 0.002); also, a statistically significant change of AVP occurred (main effect of TWI and day, p < 0.001), with no effect (TWI or day) on aldosterone and serum osmolality. Urine osmolality and volume distinguished HIGH from LOW (p = 0.002) when they consumed similar 24 h TWI.
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Affiliation(s)
- Evan C Johnson
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
- Division of Kinesiology and Health, University of Wyoming, Laramie, WY 82071, USA.
| | - Colleen X Muñoz
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
- Department of Health Sciences and Nursing, University of Hartford, West Hartford, CT 06117, USA.
| | - Liliana Jimenez
- Hydration & Health Department, Danone Research, Palaiseau 91767, France.
| | - Laurent Le Bellego
- Hydration & Health Department, Danone Research, Palaiseau 91767, France.
| | - Brian R Kupchak
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
| | - William J Kraemer
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
- Department of Human Sciences, the Ohio State University, Columbus, OH 43210, USA.
| | - Douglas J Casa
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
| | - Carl M Maresh
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
- Department of Human Sciences, the Ohio State University, Columbus, OH 43210, USA.
| | - Lawrence E Armstrong
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA.
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Pinket AS, Van Lippevelde W, De Bourdeaudhuij I, Deforche B, Cardon G, Androutsos O, Koletzko B, Moreno LA, Socha P, Iotova V, Manios Y, De Craemer M. Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries: The ToyBox-Study. PLoS One 2016; 11:e0152928. [PMID: 27064274 PMCID: PMC4827861 DOI: 10.1371/journal.pone.0152928] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background Within the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers. Method A sample of 4964 preschoolers (4.7±0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed. Results Limited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores. Conclusion The ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.
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Affiliation(s)
- An-Sofie Pinket
- Department of Public Health, Ghent University, Ghent, Belgium
- * E-mail:
| | | | | | - Benedicte Deforche
- Department of Public Health, Ghent University, Ghent, Belgium
- Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Berthold Koletzko
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children’s Hospital, München, Germany
| | - Luis A. Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Piotr Socha
- The Children’s Memorial Health Institute, Warsaw, Poland
| | - Violeta Iotova
- Dept. of pediatrics and medical Genetics, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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Benton D, Young HA. Do small differences in hydration status affect mood and mental performance? Nutr Rev 2016; 73 Suppl 2:83-96. [PMID: 26290294 DOI: 10.1093/nutrit/nuv045] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Although it has been suggested that many in the general population are dehydrated to the extent that mood and cognition are disrupted, there has been little research investigating mild levels of dehydration. When dehydration reduces body mass by more than 2%, it has been consistently reported that mood is influenced, fatigue is greater, and alertness is lower. In contrast, the effects on cognition have been less consistent. Only a few studies have looked at females and these studies made little attempt to consider hormones that influence kidney functioning. In particular, there has been virtually no attempt to look at changes in hydration status in the range that occurs in individuals with a sedentary lifestyle in a temperate climate. There is a consequent need to study individuals who have lost up to 1% of body mass due to dehydration. While 4 intervention trials have found that the cognition of children improved in response to water consumption, the effects of water consumption on cognition in older adults, another high-risk group, have been largely ignored.
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Affiliation(s)
- David Benton
- D. Benton and H. Young are with the Department of Psychology, Swansea University, Swansea, Wales, UK.
| | - Hayley A Young
- D. Benton and H. Young are with the Department of Psychology, Swansea University, Swansea, Wales, UK
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Effects of Intermittent Fasting, Caloric Restriction, and Ramadan Intermittent Fasting on Cognitive Performance at Rest and During Exercise in Adults. Sports Med 2015; 46:35-47. [DOI: 10.1007/s40279-015-0408-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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31
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Associations Among Dehydration, Testosterone and Stress Hormones in Terms of Body Weight Loss Before Competition. Am J Med Sci 2015; 350:103-8. [DOI: 10.1097/maj.0000000000000521] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Khan NA, Raine LB, Drollette ES, Scudder MR, Cohen NJ, Kramer AF, Hillman CH. The Relationship between Total Water Intake and Cognitive Control among Prepubertal Children. ANNALS OF NUTRITION AND METABOLISM 2015; 66 Suppl 3:38-41. [PMID: 26088046 DOI: 10.1159/000381245] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cognitive control (also known as executive function) encompasses mental processes that underlie goal-directed behavior, and it enables us to adjust our behavior according to changing environmental demands. Previous research among children has demonstrated that aerobic fitness and obesity have contrasting and selective effects on cognitive control. However, the relationship between water intake and childhood cognitive control remains inadequately studied. This study investigated the relationship between total water intake and cognitive control among prepubertal children (8-9-year olds). METHODS Children between 8 and 9 years of age (n = 63) performed a modified flanker task to assess cognitive control related to inhibition (ability to resist distractions and maintain focus). Diet was measured using 3-day food records. Total water was defined as water consumed from drinking water, beverages, and food. RESULTS A comparison of task performance across the median intake of total water revealed that children above the median exhibited shorter reaction times across multiple conditions of the flanker task, requiring variable amounts of cognitive control. Further, after adjustment of age, IQ, socioeconomic status, weight status, and aerobic fitness level, the proportion of intake comprised of water (%TW) was negatively correlated with reaction time interference, that is, the ability to maintain task performance when task conditions demanded greater inhibition. CONCLUSIONS These results indicate an association between water intake and cognitive control using a task that modulates inhibition. Specifically, higher water intake correlated with greater ability to maintain task performance when inhibitory demands are increased. Future work is needed to determine the mechanism by which water influences cognitive control among children.
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Affiliation(s)
- N A Khan
- Kinesiology and Community Health, University of Illinois, Urbana, Ill., USA
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33
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Bardosono S, Monrozier R, Permadhi I, Manikam NRM, Pohan R, Guelinckx I. Total fluid intake assessed with a 7-day fluid record versus a 24-h dietary recall: a crossover study in Indonesian adolescents and adults. Eur J Nutr 2015; 54 Suppl 2:17-25. [PMID: 26072215 PMCID: PMC4473025 DOI: 10.1007/s00394-015-0954-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 06/04/2015] [Indexed: 01/09/2023]
Abstract
Purpose
To compare total fluid intake (TFI), defined as the sum of water and all other fluid types, assessed with a 24-h dietary (food and fluid) recall with mean TFI assessed with a 7-day fluid-specific record among adolescents and adults. Methods
This repeated cross-sectional study compared TFI as assessed by two fluid assessment instruments using a crossover approach. 290 adolescents (17.3 ± 0.8 years, 50 % boys) and 289 adults (43 ± 9.3 years, 50 % men) from Indonesia completed the study. Results Significant correlations were observed between fluid intake assessed with the 24-h recall and the 7-day fluid record (r = 0.333; p < 0.001). The Bland–Altman method, however, showed an underestimation (bias) of mean TFI by a 24-h recall when compared with the 7-day fluid record [mean difference (95 % CI) −382 mL (−299, −465); p < 0.001]. The mean difference also increased with increasing TFI: Mean difference for the lowest and highest quartiles of TFI was 139 versus −1265 mL/day. The 7-day fluid record recorded two (95 % CI −1.9, −2.4; p < 0.0001) extra drinking acts compared with the 24-h recall, whereas the mean volume per drinking act was significantly higher with the 24-h recall [mean difference (95 % CI) 39 mL (31, 47); p < 0.001]. Conclusion Compared with a 7-day fluid record, a 24-h dietary recall significantly underestimated TFI. Subjects recalled two less drinking acts, while estimating the volume consumed per drinking act to be larger. Since the adequate intakes for total water intake are based on median intakes observed in national surveys that most frequently used the 24-h recall method, they may potentially be underestimated.
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Affiliation(s)
- Saptawati Bardosono
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Ilmu Gizi Lantai 2, Jalan Salemba Raya No. 6, Jakarta, 10430, Indonesia,
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34
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Cui F, Liu H, Zou Z, Li H. Metabolic responses to water deprivation in C57BL/6J mice using a proton nuclear magnetic resonance-based metabonomics approach. RSC Adv 2015. [DOI: 10.1039/c5ra12650a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
1H NMR-based metabonomics approach is effective for elucidating underlying mechanisms response or adaption to water deprivation in mammals. Metabolic relevance of differential compounds in response of C57BL/6J mice to water deprivation was discussed.
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Affiliation(s)
- Fengxia Cui
- Institute of Medicinal Plant Development
- Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing 100193
- China
| | - Huaqing Liu
- College of Life Science and Technology
- Beijing University of Chemical Technology
- Beijing 100029
- China
| | - Zhongmei Zou
- Institute of Medicinal Plant Development
- Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing 100193
- China
| | - Hao Li
- College of Life Science and Technology
- Beijing University of Chemical Technology
- Beijing 100029
- China
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Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol 2014; 4:257-85. [PMID: 24692140 DOI: 10.1002/cphy.c130017] [Citation(s) in RCA: 260] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This article provides a comprehensive review of dehydration assessment and presents a unique evaluation of the dehydration and performance literature. The importance of osmolality and volume are emphasized when discussing the physiology, assessment, and performance effects of dehydration. The underappreciated physiologic distinction between a loss of hypo-osmotic body water (intracellular dehydration) and an iso-osmotic loss of body water (extracellular dehydration) is presented and argued as the single most essential aspect of dehydration assessment. The importance of diagnostic and biological variation analyses to dehydration assessment methods is reviewed and their use in gauging the true potential of any dehydration assessment method highlighted. The necessity for establishing proper baselines is discussed, as is the magnitude of dehydration required to elicit reliable and detectable osmotic or volume-mediated compensatory physiologic responses. The discussion of physiologic responses further helps inform and explain our analysis of the literature suggesting a ≥ 2% dehydration threshold for impaired endurance exercise performance mediated by volume loss. In contrast, no clear threshold or plausible mechanism(s) support the marginal, but potentially important, impairment in strength, and power observed with dehydration. Similarly, the potential for dehydration to impair cognition appears small and related primarily to distraction or discomfort. The impact of dehydration on any particular sport skill or task is therefore likely dependent upon the makeup of the task itself (e.g., endurance, strength, cognitive, and motor skill).
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Affiliation(s)
- Samuel N Cheuvront
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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36
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Benton D, Young H, Jenkins K. The development of the predisposition to dehydration questionnaire. Appetite 2014; 87:76-80. [PMID: 25477317 DOI: 10.1016/j.appet.2014.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/14/2014] [Accepted: 11/24/2014] [Indexed: 11/26/2022]
Abstract
The role played by hydration in general health and well-being is an emerging public health issue, yet there are few tools available to monitor its status in large populations. The aim was therefore to develop a questionnaire that assesses individual differences in the tendency to lose body fluid in a warm environment and hence become dehydrated. Fifty-three subjects sat in a room at 30°C for four hours and changes in mood and measures of hydration were monitored. There were marked individual differences in the loss of body mass that differed from 0.24% to 2.39%. Females who reported habitually drinking a lot had more water in their diet and at baseline the osmolality of urine was lower. After being subject to heat, those who reported habitually drinking more produced more urine, had a lower urine osmolality at the end of the study, and overall more body mass was lost. Females who reported that they responded badly to heat were more confused, unsure and depressed after four hours at 30°C. In males those reporting that they habitually drank to a greater extent had more water in the diet, and also those who dealt badly with heat habitually drank more. It was concluded that particularly in females, questionnaire measures were able to predict changes in hydration that result from a warm environment.
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Affiliation(s)
- David Benton
- Department of Psychology, University of Wales Swansea, Swansea, Wales SA2 8PP, UK.
| | - Hayley Young
- Department of Psychology, University of Wales Swansea, Swansea, Wales SA2 8PP, UK
| | - Kimberley Jenkins
- Department of Psychology, University of Wales Swansea, Swansea, Wales SA2 8PP, UK
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Pross N, Demazières A, Girard N, Barnouin R, Metzger D, Klein A, Perrier E, Guelinckx I. Effects of changes in water intake on mood of high and low drinkers. PLoS One 2014; 9:e94754. [PMID: 24728141 PMCID: PMC3984246 DOI: 10.1371/journal.pone.0094754] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 02/06/2014] [Indexed: 01/08/2023] Open
Abstract
Objective To evaluate the effects of a change in water intake on mood and sensation in 22 habitual high-volume (HIGH; 2-4 L/d) and 30 low-volume (LOW; <1.2 L/d) drinkers who were asked to respectively decrease and increase their daily water intake. Method During baseline HIGH consumed 2.5 L and LOW 1 L of water/day. During 3 controlled intervention days HIGH's water intake was restricted to 1 L/day whereas LOW's was increased to 2.5 L water/day. Several mood scales (Bond & Lader Visual Analog Scale (VAS), Profile of Mood States, Karolinska Sleepiness Scale, Thirst & Emotional VAS) were administered at different time points during the study. ANOVA including intervention, time point and intervention by time point as fixed effects on mean values (i.e.; baseline data vs. mean of 3 intervention days) for each mood scale was performed. Results At baseline HIGH and LOW were comparable in mood state, except for thirst scores (estimate = 17.16, p<0.001) and POMS depression-dejection scores (estimate = 0.55, p<0.05) which were both higher in the HIGH vs. LOW. In HIGH the restricted water intake resulted in a significant increase in thirst (p<0.001) and a decrease in contentedness (p<0.05), calmness (p<0.01), positive emotions (p<0.05) and vigor/activity (p<0.001). In LOW, increased water consumption resulted in a significant decrease in fatigue/inertia (p<0.001), confusion/bewilderment (p = 0.05) and thirst (p<0.001) and a trend to lower sleepiness (p = 0.07) compared to baseline. Conclusion Increasing water intake has beneficial effects in LOW, especially sleep/wake feelings, whereas decreasing water intake has detrimental effects on HIGH's mood. These deleterious effects in HIGH were observed in some sleep/wake moods as well as calmness, satisfaction and positive emotions.
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Affiliation(s)
- Nathalie Pross
- Forenap, Rouffach, France
- Biotrial Neuroscience, Didenheim, France
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38
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Abstract
Although it is well known that water is essential for human homeostasis and survival, only recently have we begun to understand its role in the maintenance of brain function. Herein, we integrate emerging evidence regarding the effects of both dehydration and additional acute water consumption on cognition and mood. Current findings in the field suggest that particular cognitive abilities and mood states are positively influenced by water consumption. The impact of dehydration on cognition and mood is particularly relevant for those with poor fluid regulation, such as the elderly and children. We critically review the most recent advances in both behavioural and neuroimaging studies of dehydration and link the findings to the known effects of water on hormonal, neurochemical and vascular functions in an attempt to suggest plausible mechanisms of action. We identify some methodological weaknesses, including inconsistent measurements in cognitive assessment and the lack of objective hydration state measurements as well as gaps in knowledge concerning mediating factors that may influence water intervention effects. Finally, we discuss how future research can best elucidate the role of water in the optimal maintenance of brain health and function.
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Cognitive changes after saline or plasmalyte infusion in healthy volunteers: a multiple blinded, randomized, cross-over trial. Anesthesiology 2013; 119:569-75. [PMID: 23598288 DOI: 10.1097/aln.0b013e31829416ba] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In an incidental finding, during a study of plasma chemistry after crystalloid infusion, participants reported subjective cognitive changes, particularly slower thinking, after saline but not Hartmann's (Ringer's lactate) solution. The authors tested the hypothesis that saline infusion would produce greater adverse cognitive changes than Plasmalyte infusion. METHODS The authors conducted a randomized, cross-over, multiple blinded study of healthy adult volunteers. On separate days, participants received 30 ml/kg over 1 h of either 0.9% saline or Plasmalyte with the order randomly allocated. Plasma chemistry was tested on venous samples. As part of a battery of cognitive tests our primary endpoint was the reaction time index after infusion. RESULTS The authors studied 25 participants. Plasma chloride was greater after saline than after Plasmalyte: mean difference 5.4 mM (95% CI, 4.1-6.6 mM; P < 0.001). Saline was also associated with greater metabolic acidosis: base-excess 2.5 mM more negative (95% CI, 1.9-3.0 mM more negative; P < 0.001). There was no evidence of a difference in the reaction time index between the two interventions: mean reaction time index 394 ms (SD, 72) after saline versus 385 ms (SD, 55) after Plasmalyte. Difference: saline 9 ms slower (95% CI, 30 ms slower to 12 ms faster; P = 0.39). There were minimal differences in the other cognitive and mood tests. CONCLUSIONS Despite expected differences in plasma chemistry, the authors found that measures of cognition did not differ after infusions of Plasmalyte or saline.
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Edmonds CJ, Crombie R, Gardner MR. Subjective thirst moderates changes in speed of responding associated with water consumption. Front Hum Neurosci 2013; 7:363. [PMID: 23874283 PMCID: PMC3712897 DOI: 10.3389/fnhum.2013.00363] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 06/25/2013] [Indexed: 11/21/2022] Open
Abstract
Participants (N = 34) undertook a CANTAB battery on two separate occasions after fasting and abstaining from fluid intake since the previous evening. On one occasion they were offered 500 ml water shortly before testing, and on the other occasion no water was consumed prior to testing. Reaction times, as measured by Simple Reaction Time (SRT), were faster on the occasion on which they consumed water. Furthermore, subjective thirst was found to moderate the effect of water consumption on speed of responding. Response latencies in the SRT task were greater under the “no water” condition than under the “water” condition, but only for those participants with relatively high subjective thirst after abstaining from fluid intake overnight. For those participants with relatively low subjective thirst, latencies were unaffected by water consumption, and were similarly fast as those recorded for thirsty participants who had consumed water. These results reveal the novel finding that subjective thirst moderates the positive effect of fluid consumption on speed of responding. The results also showed evidence that practice also affected task performance. These results imply that, for speed of responding at least, the positive effects of water supplementation may result from an attenuation of the central processing resources consumed by the subjective sensation of thirst that otherwise impair the execution of speeded cognitive processes.
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Bankir L, Bouby N, Ritz E. Vasopressin: a novel target for the prevention and retardation of kidney disease? Nat Rev Nephrol 2013; 9:223-39. [PMID: 23438973 DOI: 10.1038/nrneph.2013.22] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
After several decades during which little attention was paid to vasopressin and/or urine concentration in clinical practice, interest in vasopressin has renewed with the availability of new, potent, orally active vasopressin-receptor antagonists--the vaptans--and with the results of epidemiological studies evaluating copeptin (a surrogate marker of vasopressin) in large population-based cohorts. Several experimental studies in rats and mice had previously shown that vasopressin, acting via vasopressin V2 antidiuretic receptors, contributes to the progression of chronic kidney disease; in particular, to autosomal dominant polycystic kidney disease. New epidemiological studies now suggest a role for vasopressin in the pathogenesis of diabetes mellitus and metabolic disorders via activation of hepatic V1a and/or pancreatic islet V1b receptors. The first part of this Review describes the adverse effects of vasopressin, as revealed by clinical and experimental studies in kidney diseases, hypertension, diabetes and the metabolic syndrome. The second part provides insights into vasopressin physiology and pathophysiology that may be relevant to the understanding of these adverse effects and that are linked to the excretion of concentrated nitrogen wastes and associated hyperfiltration. Collectively, the studies reviewed here suggest that more attention should be given to the vasopressin-thirst-urine concentration axis in clinical investigations and in patient care. Whether selective blockade of the different vasopressin receptors may provide therapeutic benefits beyond their present indication in hyponatraemia requires new clinical trials.
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Affiliation(s)
- Lise Bankir
- INSERM UMRS 872, Equipe 2, Centre de Recherche des Cordeliers, Paris, France.
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44
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Armstrong LE. Challenges of linking chronic dehydration and fluid consumption to health outcomes. Nutr Rev 2013; 70 Suppl 2:S121-7. [PMID: 23121346 DOI: 10.1111/j.1753-4887.2012.00539.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The purpose of this article is to review the effects of chronic mild dehydration and fluid consumption on specific health outcomes including obesity. The electronic databases PubMed and Google Scholar were searched for relevant literature published from the time of their inception to 2011, with results restricted to studies performed on human subjects and reports in the English language. Key words included the following: dehydration, hypohydration, water intake, fluid intake, disease, and the names of specific disease states. Strength of evidence categories were described for 1) medical conditions associated with chronic dehydration or low daily water intake, and 2) randomized-controlled trials regarding the effects of increased water consumption on caloric intake, weight gain, and satiety. This process determined that urolithiasis is the only disorder that has been consistently associated (i.e., 11 of 13 publications) with chronic low daily water intake. Regarding obesity and type 2 diabetes, evidence suggests that increased water intake may reduce caloric intake for some individuals. Recommendations for future investigations include measuring total fluid intake (water + beverages + water in solid food), conducting randomized-controlled experiments, identifying novel hydration biomarkers, and delineating hydration categories.
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Affiliation(s)
- Lawrence E Armstrong
- Department of Kinesiology, University of Connecticut, Human Performance Laboratory, Storrs, Connecticut 06269-1110, USA
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45
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Ely BR, Sollanek KJ, Cheuvront SN, Lieberman HR, Kenefick RW. Hypohydration and acute thermal stress affect mood state but not cognition or dynamic postural balance. Eur J Appl Physiol 2012; 113:1027-34. [DOI: 10.1007/s00421-012-2506-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 09/20/2012] [Indexed: 01/08/2023]
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Fadda R, Rapinett G, Grathwohl D, Parisi M, Fanari R, Calò CM, Schmitt J. Effects of drinking supplementary water at school on cognitive performance in children. Appetite 2012; 59:730-7. [PMID: 22841529 DOI: 10.1016/j.appet.2012.07.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 11/27/2022]
Abstract
We investigated the beneficial effects of drinking supplementary water during the school day on the cognitive performance and transitory subjective states, such as fatigue or vigor, in 168 children aged between 9 and 11years who were living in a hot climate (South Italy, Sardinia). The classes were randomly divided into an intervention group, which received water supplementation, and a control group. Dehydration was determined by urine sampling and was defined as urine osmolality greater than 800mOsm/kg H(2)O (Katz, Massry, Agomn, & Toor, 1965). The change in the scores from the morning to the afternoon of hydration levels, cognitive performance and transitory subjective states were correlated. In line with a previous observational study that evaluated the hydration status of school children living in a country with a hot climate (Bar-David, Urkin, & Kozminsky, 2005), our results showed that a remarkable proportion of children were in a state of mild, voluntary dehydration at the beginning of the school day (84%). We found a significant negative correlation between dehydration and the auditory number span, which indicates a beneficial effect of drinking supplementary water at school on short-term memory. Moreover, there was a positive correlation between dehydration and performance in the verbal analogy task. The results are discussed in the light of the complexity of the neurobiological mechanisms involved in the relationship between hydration status and cognition.
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Affiliation(s)
- Roberta Fadda
- Department of Pedagogy, Psychology and Philosophy, University of Cagliari, via Is Mirrionis 1, 09123 Cagliari, Italy.
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Benefer MD, Corfe BM, Russell JM, Short R, Barker ME. Water intake and post-exercise cognitive performance: an observational study of long-distance walkers and runners. Eur J Nutr 2012; 52:617-24. [DOI: 10.1007/s00394-012-0364-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/18/2012] [Indexed: 12/31/2022]
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Irwin C, Goodwin A, Leveritt M, Davey AK, Desbrow B. Alcohol pharmacokinetics and risk-taking behaviour following exercise-induced dehydration. Pharmacol Biochem Behav 2012; 101:609-16. [PMID: 22406697 DOI: 10.1016/j.pbb.2012.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 02/05/2012] [Accepted: 02/23/2012] [Indexed: 12/22/2022]
Abstract
This study investigated the influence of exercise-induced dehydration on alcohol pharmacokinetics, subjective ratings of impairment, and risk-taking behaviours. Twelve male volunteers participated in 3 experimental trials completed in a randomised cross over design separated by at least 7 days. In one trial, participants exercised to cause dehydration of ~2.5% body weight loss. For the other trials, participants were required to be in a rested and euhydrated state. A set volume of alcohol was then consumed in each trial and participants were monitored over a 4h period. Blood (BAC) and breath (BrAC) alcohol samples were collected throughout and analysed to calculate pharmacokinetic variables associated with the blood alcohol curve. Total urine production, estimates of BrAC, and subjective ratings of intoxication and impairment were also recorded throughout each trial. No difference was found in the pharmacokinetics of alcohol between any of the trial conditions. BrACs were higher than BACs for 2h following alcohol consumption, but lower at measures taken 3 and 4 h post ingestion. Participants' ratings of confusion and intoxication were significantly lower, and they were more willing to drive in the dehydration trial compared with one of the euhydration trials. These findings suggest that dehydration or other physiological changes associated with exercise may have an ability to influence the subjective effects of alcohol and increase the likelihood of risk-taking behaviours such as drink-driving. However, further research is required to examine the effects of alcohol under conditions of exercise-induced fluid loss in order to clarify these findings.
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Affiliation(s)
- Christopher Irwin
- School of Public Health & Research Centre for Clinical and Community Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
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