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Aslan Kirazoglu D, Heybeli C, Atcıyurt K, Yigitalp V, Smith L, Veronese N, Rahmati M, Soysal P. The relationship between dehydration and etiologic subtypes of major neurocognitive disorder in older patients. Eur Geriatr Med 2024:10.1007/s41999-024-00986-z. [PMID: 38755401 DOI: 10.1007/s41999-024-00986-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE Studies investigating associations between etiologic subtypes of major neurocognitive disorder (MND) and dehydration frequency are lacking. The aim of this study was to investigate the prevalence and risk factors of dehydration among older adults with and without MND (dementia), and across different etiologic subtypes of MND. METHODS This cross-sectional study included adults aged ≥ 65 years old from one geriatric outpatient clinic. Dehydration was defined as a calculated [1,86 × (Na + K) + 1,15 × glucose + urea + 14] plasma osmolarity of > 295 mOsm/L.Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. MND was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition criteria. The underlying etiologic subtypes were determined by specific diagnostic criteria. RESULTS Of the 1377 patients 72% were female, the mean age was 80 ± 8 years, and 575 had dementia. Dehydration was more common in patients with dementia than those without dementia (58% vs. 53%, p = 0.044). The prevelance of dehydration was 57%, 62%, 54%, 57% and 68% in Alzheimer's disease, Parkinson's disease dementia, fronto-temporal dementia, dementia with Lewy bodies, and vascular dementia, respectively (p ≥ 0.05). MND was associated with dehydration (OR 1.26, 95% CI 1.01-1.57; p = 0.037) after adjustment for age and sex. In multivariable analysis, among patients with dementia, hypertension, DM, CKD, and dysphagia were more common while mean Mini-Mental State Examination score was lower in those who had dehydration versus no dehydration in older patients with dementia (p < 0.05). CONCLUSION Dehydration is slightly associated with the presence of MND independent of age and sex. However, dehydration is also quite common in older patients without cognitive disorders. Therefore, hydration status should be monitored in older adults irrespective of neurocognitive status. Hypertension, DM, CKD, dysphagia and severity of cognitive dysfunction were associated with dehydration in patients with dementia. The prevalence of dehydration is highest in patients with vascular dementia.
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Affiliation(s)
- Damla Aslan Kirazoglu
- Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Cihan Heybeli
- Division of Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Kübra Atcıyurt
- Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Veliye Yigitalp
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093, Fatih, Istanbul, Turkey
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093, Fatih, Istanbul, Turkey.
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Davis KM, Rosinger AY, Murdock KW. Ex vivo LPS-stimulated cytokine production is associated with hydration status in community-dwelling middle-to-older-aged adults. Eur J Nutr 2023; 62:1681-1690. [PMID: 36790579 DOI: 10.1007/s00394-023-03105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE Suboptimal hydration has been linked to a variety of adverse health outcomes. Few studies have examined the impact of hydration status on immune function, a plausible physiological mechanism underlying these associations. Therefore, we tested how variation in hydration status was associated with circulating pro-inflammatory cytokine levels and ex vivo lipopolysaccharide (LPS)-stimulated pro-inflammatory cytokine production. METHODS Blood samples were obtained from a community sample of healthy middle-to-older-aged adults (N = 72). These samples were used to assess serum osmolality, a biomarker of hydration status, and markers of immune function including circulating pro-inflammatory cytokines and stimulated pro-inflammatory cytokine production after 4 and 24 h of incubation with LPS. Multiple linear regressions were used to test the association between serum osmolality (as a continuous variable) and markers of immune function at baseline and after 4 and 24 h adjusting for age, sex, and BMI. These models were re-estimated with serum osmolality dichotomized at the cut-off for dehydration (> 300 mOsm/kg). RESULTS While not significantly associated with circulating cytokines (B = - 0.03, p = 0.09), serum osmolality was negatively associated with both 4 h (B = - 0.05, p = 0.048) and 24 h (B = - 0.05, p = 0.03) stimulated cytokine production when controlling for age, sex, and BMI. Similarly, dehydration was associated with significantly lower cytokine production at both 4 h (B = - 0.54, p = 0.02) and 24 h (B = - 0.51, p = 0.02) compared to adequate hydration. CONCLUSION These findings suggest that dehydration may be associated with suppressed immune function in generally healthy middle-to-older aged community-dwelling adults. Further longitudinal research is needed to more clearly define the role of hydration in immune function.
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Affiliation(s)
- Kristin M Davis
- Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA.,Department of Anthropology, Pennsylvania State University, University Park, PA, USA
| | - Kyle W Murdock
- Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA.
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Huang L, Ng JWC, Lee JKW. Nutrition Recommendations for Table Tennis Players-A Narrative Review. Nutrients 2023; 15:nu15030775. [PMID: 36771479 PMCID: PMC9920626 DOI: 10.3390/nu15030775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Table tennis (TT) is the second most popular racket sport globally and was the sixth most widely played Olympic sport in 2005. It is an indoor racket sport requiring a mixture of power, agility, alertness and fast reactions. Players need to move quickly around a table to receive the ball and produce powerful returns. New rules such as increased ball size and a change in ball material have changed the ball's trajectory, increasing the overall duration and intensity of game play. Scientific research on TT is growing but there has been no systematic review of nutrition for the sport. This review provides nutritional recommendations for TT athletes based on the physiological demands of TT, including energy expenditure during training and competitions, and the main metabolic pathways of TT. Guidelines on the daily intakes of carbohydrate, protein and fat are discussed in addition to hydration strategies. Micronutrients of concern for TT athletes include iron, magnesium and vitamin D and their recommended intakes are also provided. The timing and dose of ergogenic aids that may improve TT performance such as caffeine, creatine, lutein and zeaxanthin and beta-alanine are reviewed. Specific nutritional strategies for intakes leading up to competitions, post training and competition recovery and nutritional strategies for travel are also addressed.
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Affiliation(s)
- Liyan Huang
- Sport Science and Medicine Center, Singapore Sport Institute 3 Stadium Drive, Singapore 397630, Singapore
- Correspondence: ; Tel.: +65-6500-5488
| | - Jeremy W. C. Ng
- High Performance Department, Singapore Table Tennis Association, 297-C Lor 6 Toa Payoh, Singapore 319389, Singapore
| | - Jason K. W. Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
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Makowski MS, Trockel MT, Menon NK, Wang H, Katznelson L, Shanafelt TD. Performance Nutrition for Physician Trainees Working Overnight Shifts: A Randomized Controlled Trial. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:426-435. [PMID: 34753859 DOI: 10.1097/acm.0000000000004509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To compare acute effects of 2 dietary interventions with usual dietary habits on physician trainees' alertness during overnight shifts. METHOD This registered, controlled, block randomized crossover trial (NCT03698123) was conducted between October 2018 and May 2019 at Stanford Medicine. Physician trainees working at least 3 overnight shifts during a 1-week period were recruited. During the first night, participants followed their usual dietary habits. During the intervention nights (low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions), participants received healthy dinners, snacks, water, and, upon request, caffeinated beverages, at the beginning of their shifts and were instructed to eat meals before 10 pm. The sequence of interventions on the second and third nights were block randomized across study weeks. Outcome measures (a priori) were overnight changes in validated measures of specific neurobehavioral dimensions: psychomotor vigilance, sensory-motor speed, working memory, and risk decision making, as well as self-reported sleepiness and work exhaustion. RESULTS Sixty-one physician trainees participated in this study. Compared with usual dietary habits, overnight changes in psychomotor vigilance scores (scale 0-1,000) improved by 51.02 points (95% CI: 12.08, 89.96) and sleepiness (scale 1-7) improved by 0.69 points (95% CI: 0.33, 1.05) under the low carbohydrate-to-protein ratio intervention. Compared with usual dietary habits, overnight changes in sleepiness (scale 1-7) improved by 0.61 points (95% CI: 0.25, 0.96) under the high carbohydrate-to-protein ratio intervention. Neither intervention had beneficial effects relative to usual dietary habits with respect to sensory-motor speed, working memory, risk decision making, or work exhaustion. There were no differences in outcomes between low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio interventions. CONCLUSIONS Dietary interventions may mitigate negative effects of physician trainee sleep deprivation during overnight shifts. Future studies are warranted to further examine the effectiveness of nutritional strategies on physician alertness during overnight shifts.
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Affiliation(s)
- Maryam S Makowski
- M.S. Makowski is clinical assistant professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0003-0823-5376
| | - Mickey T Trockel
- M.T. Trockel is clinical professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0001-7191-5791
| | - Nikitha K Menon
- N.K. Menon is social science research professional, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0001-6443-1561
| | - Hanhan Wang
- H. Wang is a biostatistician, Stanford Medicine WellMD and WellPhD Center, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0003-4076-3443
| | - Laurence Katznelson
- L. Katznelson is professor of neurosurgery and medicine, Departments of Neurosurgery and Medicine, and associate dean of graduate medical education, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0001-8115-5714
| | - Tait D Shanafelt
- T.D. Shanafelt is professor of medicine, Department of Medicine, chief wellness officer, Stanford Medicine, and associate dean, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0002-7106-5202
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Albasheer OB, Hakami A, Al Faqih AA, Akkam I, Soraihy SK, Mathary A, Alharbi AA, Yaqoub M, Alotayfi MA. Awareness of dehydration state and fluid intake practice among adults population in the Jazan Region of Saudi Arabia, 2019. J Nutr Sci 2021; 10:e84. [PMID: 34733496 PMCID: PMC8532066 DOI: 10.1017/jns.2021.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 01/04/2023] Open
Abstract
Despite the hot climate and high humidity in the Jazan Region of Saudi Arabia, which increases risk for dehydration, no previous studies have assessed awareness of dehydration and fluid intake practice among adults in this region. Therefore, the aim of this cross-sectional study was to determine awareness of the dehydration state and fluid intake practices among 440 adults in the Jazan Region of Saudi Arabia. Out of the total, 51⋅8 % were male and 48⋅2 % were females. Good knowledge of dehydration definition and prevention and recommended minimum water intake was observed in 98, 95 and 75 % of the participants, respectively. Fifty-nine percent of the participants met the minimum daily requirement of 3 l or more per day. The age (95 % CI 1⋅003, 1⋅017, P value = 0⋅006), diabetes (95 % CI 1⋅028, 1⋅459, P value = 0⋅023) and prior hospitalisation due to dehydration (95 % CI 1⋅010, 1⋅378, P value = 0⋅037) were associated with higher water intake. Additional glasses of coffee (95 % CI 1⋅02, 1⋅115, P value = 0⋅004) and juice (95 % CI 1⋅039, 1⋅098, P value < 0⋅001) were associated with more water intake. The participants exhibited good knowledge of dehydration definition, symptoms and consequences. Intake of fluids such as 'juice and coffee' enhances more water intake. Although two-thirds of the participants met the recommended daily water intake, still one-third of them did not meet this level. Innovative approaches to enhance healthy drinking are warranted and may include partnering with patients to take an active role in hydration monitoring and increasing communication with the different healthcare providers.
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Affiliation(s)
- Osama B. Albasheer
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abdullah Hakami
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | | | - Ibrahim Akkam
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Safwan K. Soraihy
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmad Mathary
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ali A. Alharbi
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohammed Yaqoub
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Majed A. Alotayfi
- Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
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Cellular dehydration acutely degrades mood mainly in women: a counterbalanced, crossover trial. Br J Nutr 2021; 125:1092-1100. [PMID: 33077017 DOI: 10.1017/s0007114520003475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
It is unclear if mild-to-moderate dehydration independently affects mood without confounders like heat exposure or exercise. This study examined the acute effect of cellular dehydration on mood. Forty-nine adults (55 % female, age 39 (sd 8) years) were assigned to counterbalanced, crossover trials. Intracellular dehydration was induced with 2-h (0·1 ml/kg per min) 3 % hypertonic saline (HYPER) infusion or 0·9 % isotonic saline (ISO) as a control. Plasma osmolality increased in HYPER (pre 285 (sd 3), post 305 (sd 4) mmol/kg; P < 0·05) but remained unchanged in ISO (pre 285 (sd 3), post 288 (sd 3) mmol/kg; P > 0·05). Mood was assessed with the short version of the Profile of Mood States Questionnaire (POMS). The POMS sub-scale (confusion-bewilderment, depression-dejection, fatigue-inertia) increased in HYPER compared with ISO (P < 0·05). Total mood disturbance score (TMD) assessed by POMS increased from 10·3 (sd 0·9) to 16·6 (sd 1·7) in HYPER (P < 0·01), but not in ISO (P > 0·05). When TMD was stratified by sex, the increase in the HYPER trial was significant in females (P < 0·01) but not in males (P > 0·05). Following infusion, thirst and copeptin (surrogate for vasopressin) were also higher in females than in males (21·3 (sd 2·0), 14·1 (sd 1·4) pmol/l; P < 0·01) during HYPER. In conclusion, cellular dehydration acutely degraded specific aspects of mood mainly in women. The mechanisms underlying sex differences may be related to elevated thirst and vasopressin.
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Nsiah-Asamoah CNA, Buxton DNB. Hydration and water intake practices of commercial long-distance drivers in Ghana: what do they know and why does it matter? Heliyon 2021; 7:e06512. [PMID: 33851041 PMCID: PMC8022146 DOI: 10.1016/j.heliyon.2021.e06512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/04/2021] [Accepted: 03/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The World Health Organization indicates that hydration is indispensable to human life. A long-period of dehydration can result in fatigue, drowsiness and mental confusion which can result in committing serious blunders. For commercial drivers, however, these blunders can be life-threatening and their hydration cannot be overemphasized. AIM This study was therefore undertaken to assess the water intake practices of Commercial Long-Distance drivers (CLDDs). The study was also aimed at assessing their knowledge levels on the role of water in promoting a healthy body and the consequences of dehydration. SETTING CLDDs in Ghana who ply between Accra - Cape Coast - Takoradi or Accra - Kumasi. METHODS A cross-sectional study which involved 256 CLDDs was conducted at six (6) commercial bus stations in Accra and Cape Coast from December 2019 to January 2020. Structured questionnaires were administered to obtain socio-demographic and water intake practices of CLDDs. SPSS was used to generate descriptive statistics based on the data collected. RESULTS A high proportion (57.8%) of the CLDDs reported that they drunk about 2500ml-3000ml of water on a daily basis. Most (53.1%) relied on their thirst feeling to prompt them to drink water. A little over half (51.1%) consumed energy drinks believed to hydrate the body. A major barrier to drinking water regularly was to avoid frequent stop-overs to use the washroom while travelling. CONCLUSION The findings reveal concerns about knowledge gaps with regard to the importance of water consumption and barriers to adequate drinking of water among CLDDs. Findings also suggest that many CLDDs relied on their thirst perceptions to prompt them to drink water. Health Education programmes targeting CLDDs should include conveying the importance of water intake and healthy hydration practices for optimal physical and cognitive performance.
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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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Wolkoff P, Azuma K, Carrer P. Health, work performance, and risk of infection in office-like environments: The role of indoor temperature, air humidity, and ventilation. Int J Hyg Environ Health 2021; 233:113709. [PMID: 33601136 DOI: 10.1016/j.ijheh.2021.113709] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Epidemiological and experimental studies have revealed the effects of the room temperature, indoor air humidity, and ventilation on human health, work and cognitive performance, and risk of infection. In this overview, we integrate the influence of these important microclimatic parameters and assess their influence in offices based on literature searches. The dose-effect curves of the temperature describe a concave shape. Low temperature increases the risk of cardiovascular and respiratory diseases and elevated temperature increases the risk of acute non-specific symptoms, e.g., dry eyes, and respiratory symptoms. Cognitive and work performance is optimal between 22 °C and 24 °C for regions with temperate or cold climate, but both higher and lower temperatures may deteriorate the performances and learning efficiency. Low temperature may favor virus viability, however, depending on the status of the physiological tissue in the airways. Low indoor air humidity causes vulnerable eyes and airways from desiccation and less efficient mucociliary clearance. This causes elevation of the most common mucous membrane-related symptoms, like dry and tired eyes, which deteriorates the work performance. Epidemiological, experimental, and clinical studies support that intervention of dry indoor air conditions by humidification alleviates symptoms of dry eyes and airways, fatigue symptoms, less complaints about perceived dry air, and less compromised work performance. Intervention of dry air conditions by elevation of the indoor air humidity may be a non-pharmaceutical treatment of the risk of infection by reduced viability and transport of influenza virus. Relative humidity between 40 and 60% appears optimal for health, work performance, and lower risk of infection. Ventilation can reduce both acute and chronic health outcomes and improve work performance, because the exposure is reduced by the dilution of the indoor air pollutants (including pathogens, e.g., as virus droplets), and in addition to general emission source control strategies. Personal control of ventilation appears an important factor that influences the satisfaction of the thermal comfort due to its physical and positive psychological impact. However, natural ventilation or mechanical ventilation can become sources of air pollutants, allergens, and pathogens of outdoor or indoor origin and cause an increase in exposure. The "health-based ventilation rate" in a building should meet WHO's air quality guidelines and dilute human bio-effluent emissions to reach an acceptable perceived indoor air quality. Ventilation is a modifying factor that should be integrated with both the indoor air humidity and the room temperature in a strategic joint control to satisfy the perceived indoor air quality, health, working performance, and minimize the risk of infection.
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Affiliation(s)
- Peder Wolkoff
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Kenichi Azuma
- Dept Environmental Medicine and Behavioral Science, Kindai University, Faculty of Medicine, Osakasayama, Osaka, Japan.
| | - Paolo Carrer
- Dept Biomedical and Clinical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy.
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Does Hydration Status Influence Executive Function? A Systematic Review. J Acad Nutr Diet 2021; 121:1284-1305.e1. [PMID: 33547031 DOI: 10.1016/j.jand.2020.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cognitive function, including executive function (EF)-related capacities (eg, working memory, inhibitory and attentional control), has been linked to adherence to healthy lifestyle behaviors. Dehydration is associated with impaired cognitive function, whereas improvements in hydration status may improve inhibitory and attentional performance. No systematic reviews have examined the effects of both dehydration and euhydration on EF. OBJECTIVE The objectives of this systematic review are to examine studies that have investigated the spectrum of hydration status and EF in adults, and to identify future research needs. DESIGN The review was conducted according to the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. The database search was initially conducted on May 12, 2019 and then updated on April 26, 2020. Databases searched included PubMed, Medline, Psyc Info, SCOPUS, Proquest, and ISI Web of Science. Data extraction included the following: method used to assess de/hydration status, study design, participant characteristics, EF tasks and domain, and results. Article quality ratings were performed on included studies using the Academy of Nutrition and Dietetics Quality Rating Checklist. PARTICIPANTS/SETTING Studies done with healthy or diseased adults, aged older than 18 years, in any setting, were included. Studies of individuals with disease states that impact fluid balance or require fluid restrictions as treatments were excluded. MAIN OUTCOME MEASURE All EF-related outcomes were included, such as working memory, inhibitory control, task switching, and attention. RESULTS Four thousand eight hundred thirty-three articles were screened using title/abstracts. Seventy-one full-text articles were assessed for eligibility; 33 were included (26 included investigations of dehydration; 27 included investigations of rehydration/euhydration) with 3,636 participants across all studies. Little consistency was found across outcomes. Roughly half of the available studies suggested unclear or neutral EF effects, and half suggested effects on EF domains, particularly working memory, inhibitory control, and attention. Studies including a euhydration condition were slightly more likely to demonstrate improvements to EF capacities. CONCLUSIONS Overall, there is a strong need for consistent methodological approaches and a greater number of long-term (ie, >3 days) studies of dehydration and euhydration and EF.
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The Emergence of eSports Nutrition: A Review. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2021. [DOI: 10.18276/cej.2021.1-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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He H, Zhang J, Zhang N, Du S, Liu S, Ma G. Effects of the Amount and Frequency of Fluid Intake on Cognitive Performance and Mood among Young Adults in Baoding, Hebei, China: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238813. [PMID: 33260939 PMCID: PMC7731196 DOI: 10.3390/ijerph17238813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022]
Abstract
Water is a critical nutrient that is important for the maintenance of the physiological function of the human body. This article aimed to investigate the effects of the amount and frequency of fluid intake on cognitive performance and mood. A double-blinded randomized controlled trial was designed and implemented on college students aged 18–23 years in Baoding, China. Participants were randomly assigned into one of three groups: the recommended behavior group (RB group) who drank 200 mL of water every 2 h, the half amount group (HA group) who drank 100 mL of water every 2 h, and the high frequency group (HF group) who drank 110 mL of water every 1 h. The intervention lasted 2 days. Urine osmolality, cognitive performance, and mood of participants in each group were compared using the one-way analysis of variance (ANOVA). A total of 92 participants (46 females, 46 males) completed this study with a completion rate of 95.8%. The urine osmolality of the HA group was higher than that of the RB group and the HF group at two time points (p < 0.05). At time point 1, the scores in the portrait memory test and vigor were statistically different (F = 20.45, p < 0.001; F = 5.46, p = 0.006). It was found that the scores for the portrait memory test in the RB group were lower than those in the HA group and the HF group (p = 0.007; p < 0.001), while the scores of the HF group were higher than those of the HA group (p < 0.001). The scores for vigor in the RB group were significantly higher than those of the HA group (p = 0.006), and they were also significantly higher than those of the HF group (p = 0.004). At time point 2, only the scores for vigor were statistically different (F = 3.80, p = 0.026). It was found that the scores for vigor in the RB group were higher than those in the HA group and HF group (p = 0.018; p = 0.019). Both the amount and frequency of fluid intake may affect urine osmolality and vigor, but these factors have limited impacts on cognitive performance. Rational fluid intake behavior may be beneficial to improve the hydration status and mood of young adults. More research is needed, especially experimental research, to allow causal conclusions to be drawn.
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Affiliation(s)
- Hairong He
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (H.H.); (J.Z.); (N.Z.)
| | - Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (H.H.); (J.Z.); (N.Z.)
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (H.H.); (J.Z.); (N.Z.)
| | - Songming Du
- Chinese Nutrition Society, Beijing 100053, China;
| | - Shufang Liu
- Health Science Center, Hebei University, Baoding 071000, China;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (H.H.); (J.Z.); (N.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
- Correspondence: ; Tel./Fax: +86-10-8280-5266
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Zhang J, Zhang N, He H, Du S, Ma G. Different Amounts of Water Supplementation Improved Cognitive Performance and Mood among Young Adults after 12 h Water Restriction in Baoding, China: A Randomized Controlled Trial (RCT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217792. [PMID: 33114364 PMCID: PMC7662706 DOI: 10.3390/ijerph17217792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/26/2022]
Abstract
Water is indispensable to keeping the functions of the human body working properly, including that of the brain. The purpose of this research was to explore the impacts of water supplementation on cognitive performance and mood, and to determine the optimum amount of water to alleviate detriments of dehydration after 12 h water restriction. A randomized controlled trial was implemented among 64 young adults from Baoding, China. Fasting overnight for 12 h, and at 8:00 a.m. on day 2, osmolality of first morning urine and blood, cognitive performance, and mood were assessed as the dehydration test. Then, participants were randomly separated into four groups: water supplementation groups (WS groups 1, 2, and 3 with 500, 200, and 100 mL purified water, respectively) and no water supplementation group (NW group). Participants in WS groups were instructed to drink the water within 10 min, while those in NW group drank no water. After 90 min, the same measurements were taken as the rehydration test. There was significant interaction between TIME and VOLUME in thirst when comparing dehydration with rehydration tests (F = 6.172, p = 0.001). Significant thirst reductions were found in WS group 1 and WS group 2 (p = 0.003; p = 0.041), and a significant increase was found in the NW group (p = 0.039). In the rehydration test, significant interactions between TIME and VOLUME were found in scores of anger, fatigue, and TMD (total mood disturbance) (F = 3.815, p = 0.014; F = 10.429, p < 0.001; F = 5.246, p < 0.001), compared to the dehydration test. Scores of anger were only decreased in WS group 2 (p = 0.025), and scores of fatigue and TMD decreased in WS group 1 and WS group 2 (all p < 0.05). Significant interaction between TIME and VOLUME was only found for operation span test scores (F = 2.816, p = 0.047), with scores being only higher in WS group 1 in the rehydration test compared to the dehydration test (p = 0.003). Comparing WS group 1 and WS group 2, scores of thirst, fatigue, and TMD did not differ significantly (p > 0.05). Water supplementation improved working memory and attenuated anger, fatigue, and TMD. A small amount of water (200 mL) was sufficient to attenuate thirst, anger, fatigue, and TMD of young adults, but the larger volume (500 mL) appeared to be necessary to improve working memory. The amount of 500 mL was the optimum volume to improve the cognitive performance and mood among young adults.
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Affiliation(s)
- Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (N.Z.); (H.H.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (N.Z.); (H.H.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
| | - Hairong He
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (N.Z.); (H.H.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
| | - Songming Du
- Chinese Nutrition Society, Beijing 100053, China;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.Z.); (N.Z.); (H.H.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
- Correspondence: ; Tel./Fax: +86-10-8280-5266
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Munson EH, Orange ST, Bray JW, Thurlow S, Marshall P, Vince RV. Sodium Ingestion Improves Groundstroke Performance in Nationally-Ranked Tennis Players: A Randomized, Placebo-Controlled Crossover Trial. Front Nutr 2020; 7:549413. [PMID: 33072795 PMCID: PMC7536336 DOI: 10.3389/fnut.2020.549413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
This study examined the dose-response effects of ingesting different sodium concentrations on markers of hydration and tennis skill. Twelve British nationally-ranked tennis players (age: 21.5 ± 3.1 years; VO2peak: 45.5 ± 4.4 ml.kg.min-1) completed four identical in-door tennis training sessions in a cluster randomized, single-blind, placebo-controlled, crossover design. Twenty-minutes prior to each training session, participants consumed a 250 ml sodium-containing beverage (10, 20, 50 mmol/L) or a placebo (0 mmol/L), and continued to consume 1,000 ml of the same beverage at set periods during the 1-h training session. Tennis groundstroke and serve performance, agility, urine osmolality, fluid loss, sodium sweat loss and perceptual responses (rating of perceived exertion (RPE), thirst, and gastrointestinal (GI) discomfort) were assessed. Results showed that ingesting 50 mmol/L sodium reduced urine osmolality (-119 mOsmol/kg; p = 0.037) and improved groundstroke performance (5.4; p < 0.001) compared with placebo. This was associated with a reduction in RPE (-0.42; p = 0.029), perception of thirst (-0.58; p = 0.012), and GI discomfort (-0.55; p = 0.019) during the 50 mmol/L trial compared with placebo. Linear trend analysis showed that ingesting greater concentrations of sodium proportionately reduced urine osmolality (β = -147 mOsmol/kg; p = 0.007) and improved groundstroke performance (β = 5.6; p < 0.001) in a dose response manner. Perceived thirst also decreased linearly as sodium concentration increased (β = -0.51; p = 0.044). There was no evidence for an effect of sodium consumption on fluid loss, sweat sodium loss, serve or agility performance (p > 0.05). In conclusion, consuming 50 mmol/L of sodium before and during a 1-h tennis training session reduced urine osmolality and improved groundstroke performance in nationally-ranked tennis players. There was also evidence of dose response effects, showing that ingesting greater sodium concentrations resulted in greater improvements in groundstroke performance. The enhancement in tennis skill may have resulted from an attenuation of symptomologic distracters associated with hypohydration, such as RPE, thirst and GI discomfort.
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Affiliation(s)
- Edward H Munson
- Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Samuel T Orange
- School of Biomedical, Nutritional, and Sport Sciences, Faculty of Medical Sciences, The Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - James W Bray
- Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Shane Thurlow
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, United Kingdom
| | - Philip Marshall
- Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Rebecca V Vince
- Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull, United Kingdom
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15
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Water Consumption during a School Day and Children's Short-Term Cognitive Performance: The CogniDROP Randomized Intervention Trial. Nutrients 2020; 12:nu12051297. [PMID: 32370147 PMCID: PMC7282257 DOI: 10.3390/nu12051297] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
There is still little research examining the relationship between water consumption in school and specific cognitive performance. The aim of this cluster-randomized intervention CogniDROP trial was to investigate the short-term effects of drinking water during the morning on executive functions. The participants were from the 5th and 6th grade of a comprehensive school in Germany (14 classes, n = 250, 61.6% boys). The classes were randomly divided into an intervention group (an education on healthy drinking behavior and a promotion of water consumption) and a control group. A battery of computerized tasks (Switch Task, 2-Back Task, Corsi Block-Tapping Task and Flanker Task) was used to test executive functions. Urine color and thirst were evaluated to check the hydration level. Physical activity over the past 24 h was measured using GT3X ActiGraph. A non-linear relationship was observed between the amount of drinking water and executive performance. Consuming water up to 1000 mL (or up to 50% of Total Water Intake) had benefits during memory tasks. Urine color and number of steps on the study day correlated with water consumed. The results suggest that a water-friendly environment supports school-aged children in adequate water intake resulting in better cognitive performance, especially short-term memory.
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16
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Rosinger AY, Chang AM, Buxton OM, Li J, Wu S, Gao X. Short sleep duration is associated with inadequate hydration: cross-cultural evidence from US and Chinese adults. Sleep 2020; 42:5155420. [PMID: 30395316 DOI: 10.1093/sleep/zsy210] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Indexed: 01/11/2023] Open
Abstract
Study Objectives Short and long sleep durations are linked to reduced kidney function, but little research has examined how sleep is associated with hydration status. Our aim was to assess the relationship between sleep duration and urinary hydration biomarkers among adults in a cross-cultural context. Methods Three samples of adults aged ≥20 years were analyzed: 2007-2008 National Health and Nutrition Examination Survey (NHANES; n = 4680), 2009-2012 NHANES (n = 9559), and 2012 cross-sectional wave of the Chinese Kailuan Study (n = 11903), excluding pregnant women and adults with failing kidneys. We estimated multiple linear regression models between self-reported usual night-time sleep duration (<6, 6, 7, 8 (reference), and ≥9 hr/day) and urine specific gravity (Usg) and urine osmolality (Uosm) as continuous variables and logistic regression models dichotomized as inadequate hydration (>1.020 g/mL; >831 mOsm/kg). In primary analyses, we estimated models excluding diabetes and diuretic medications for healthier subpopulations (NHANES, n = 11353; Kailuan, n = 8766). Results In the healthier NHANES subset, 6 hr was associated with significantly higher Usg and odds of inadequate hydration (adjusted OR: 1.59, 95% CI: 1.25, 2.03) compared with 8 hr. Regression results were mixed using Uosm, but in the same direction as Usg. Among Chinese adults, short sleep duration (<6 and 6 hr) was associated with Usg and higher likelihood of inadequate hydration (6 hr adjusted OR: 1.42, 95% CI: 1.26, 1.60). No consistent association was found with sleeping ≥9 hr. Conclusions Short sleep duration was associated with higher odds of inadequate hydration in US and Chinese adults relative to sleeping 8 hr.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Department of Anthropology, Pennsylvania State University, State College, PA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA.,Division of Sleep Medicine, Harvard Medical School, Harvard University, Cambridge, MA
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutrition, Pennsylvania State University, State College, PA
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17
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Benton D, Young HA. Water: The Cinderella Nutrient. J Nutr 2019; 149:2081-2082. [PMID: 31515559 DOI: 10.1093/jn/nxz226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/23/2019] [Indexed: 01/22/2023] Open
Affiliation(s)
- David Benton
- Department of Psychology, Swansea University, Wales, United Kingdom
| | - Hayley A Young
- Department of Psychology, Swansea University, Wales, United Kingdom
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18
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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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19
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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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20
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Rosinger AY. Biobehavioral variation in human water needs: How adaptations, early life environments, and the life course affect body water homeostasis. Am J Hum Biol 2019; 32:e23338. [PMID: 31631450 DOI: 10.1002/ajhb.23338] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/15/2019] [Accepted: 09/17/2019] [Indexed: 01/22/2023] Open
Abstract
Body water homeostasis is critical for optimal physiological and cognitive function for humans. The majority of research has illustrated the negative biological consequences of failing to meet water needs. The human body has several mechanisms for detecting, regulating, and correcting body water deficits and excesses. However, variation exists in total water intake and how people meet those water needs as well as thirst thresholds and how well people tolerate water restriction. An evolutionary and developmental framework provides an underexplored perspective into human water needs by examining how adaptations, early life experiences and environments, as well as life course changes in health states and behaviors may shape these critical factors in body water homeostasis. This article first reviews biological and behavioral adaptations to water scarcity among animals and humans. It then examines human variation in water intake in a mostly water secure environment through the analysis of National Health and Nutrition Examination Survey dietary data and the link between water intake patterns and hydration biomarkers. Next, it reviews existing evidence of how maternal water restriction in utero and during lactation shape vasopressin release, thirst thresholds, drinking patterns, and body water homeostasis for the infant. Early life water restriction appears to have implications for hydration status, body size, and cardiovascular health. Finally, it examines how life course changes in health states and behaviors, including obesity, sleep, and parasitic infection, affect body water homeostasis. This article poses new questions about the plasticity and shaping of human water needs, thirst, and hydration behaviors.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania.,Department of Anthropology, Pennsylvania State University, State College, Pennsylvania
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21
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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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22
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Hydration Status and Cardiovascular Function. Nutrients 2019; 11:nu11081866. [PMID: 31405195 PMCID: PMC6723555 DOI: 10.3390/nu11081866] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 02/07/2023] Open
Abstract
Hypohydration, defined as a state of low body water, increases thirst sensations, arginine vasopressin release, and elicits renin–angiotensin–aldosterone system activation to replenish intra- and extra-cellular fluid stores. Hypohydration impairs mental and physical performance, but new evidence suggests hypohydration may also have deleterious effects on cardiovascular health. This is alarming because cardiovascular disease is the leading cause of death in the United States. Observational studies have linked habitual low water intake with increased future risk for adverse cardiovascular events. While it is currently unclear how chronic reductions in water intake may predispose individuals to greater future risk for adverse cardiovascular events, there is evidence that acute hypohydration impairs vascular function and blood pressure (BP) regulation. Specifically, acute hypohydration may reduce endothelial function, increase sympathetic nervous system activity, and worsen orthostatic tolerance. Therefore, the purpose of this review is to present the currently available evidence linking acute hypohydration with altered vascular function and BP regulation.
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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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24
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Liska D, Mah E, Brisbois T, Barrios PL, Baker LB, Spriet LL. Narrative Review of Hydration and Selected Health Outcomes in the General Population. Nutrients 2019; 11:nu11010070. [PMID: 30609670 PMCID: PMC6356561 DOI: 10.3390/nu11010070] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/07/2018] [Accepted: 12/27/2018] [Indexed: 12/16/2022] Open
Abstract
Although adequate hydration is essential for health, little attention has been paid to the effects of hydration among the generally healthy population. This narrative review presents the state of the science on the role of hydration in health in the general population, specifically in skin health, neurological function (i.e., cognition, mood, and headache), gastrointestinal and renal functions, and body weight and composition. There is a growing body of evidence that supports the importance of adequate hydration in maintaining proper health, especially with regard to cognition, kidney stone risk, and weight management. However, the evidence is largely associative and lacks consistency, and the number of randomized trials is limited. Additionally, there are major gaps in knowledge related to health outcomes due to small variations in hydration status, the influence of sex and sex hormones, and age, especially in older adults and children.
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Affiliation(s)
- DeAnn Liska
- Biofortis, Mérieux NutriSciences, Addison, IL 60101, USA.
| | - Eunice Mah
- Biofortis, Mérieux NutriSciences, Addison, IL 60101, USA.
| | | | | | - Lindsay B Baker
- Gatorade Sports Science Institute, Barrington, IL 60010, USA.
| | - Lawrence L Spriet
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W, Canada.
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25
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Shaheen NA, Alqahtani AA, Assiri H, Alkhodair R, Hussein MA. Public knowledge of dehydration and fluid intake practices: variation by participants' characteristics. BMC Public Health 2018; 18:1346. [PMID: 30518346 PMCID: PMC6282244 DOI: 10.1186/s12889-018-6252-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 11/22/2018] [Indexed: 12/19/2022] Open
Abstract
Background Dehydration results from a decrease in total body water content either due to less intake or more fluid loss. Common symptoms of dehydration are dry mouth/tongue, thirst, headache, and lethargy. The aim of this study was to assess knowledge of dehydration definition, symptoms, causes, prevention, water intake recommendations and water intake practices among people living in Riyadh, Saudi Arabia. Methods A cross-sectional study using self-reported questionnaire was employed. Participants were invited during their visit to shopping malls. The shopping malls were selected based on geographical location covering east, west, north and southern part of the city. Self-filled questionnaires were distributed to 393 participants, using systematic sampling technique. Variables recorded included demographics, past medical history, knowledge of dehydration definition, symptoms, causes, prevention and daily water intake practices. Descriptive statistics were summarised as mean, standard deviation and proportions. Negative binomial model was used to identify the predictors of water intake. Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC, USA). Results Out of 393 participants, 273(70%) were Saudi, 209(53%) were female, average age was 32.32 ± 8.78 years. Majority 366(93%) had good knowledge of dehydration definition, 332(84%) for dehydration prevention, and 293(74%) of water intake recommendation. Top three recognized dehydration symptoms were: dry lips (87%), thirst (84%), dry tongue (76%) and recognized dehydration causes were: diarrhoea (81%), sweating (68%) and vomiting (62%). The less recognized symptoms were fatigue 176(44.78%), lack of focus 171(43.5%), headache/dizziness 160(40.71%), light headedness 117(29.7%), muscle weakness 98(24.94%), rapid breathing 90(22.9%), and muscle cramps 64(16.28%).The participants had reported an average of 5.39 ± 3.32 water glasses intake per day. The total volume of water intake was significantly different between males n = 184 (3.935 ± 2.10 l) and females n = 209 (3.461 ± 2.59 l) (p = 0.046). The participants’ weight status, intake of juice or tea were the significant predictors of more water intake. Conclusion The participants displayed good knowledge of dehydration definition, prevention, and water intake recommendation. The participants also displayed good knowledge of the common symptoms, however knowledge was lacking for uncommon symptoms. Moreover, participants had reported adequate water intake, meeting the daily water intake recommendation of ≥3.7 l for men and ≥ 2.7 l for women. Electronic supplementary material The online version of this article (10.1186/s12889-018-6252-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naila A Shaheen
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Kingdom of Saudi Arabia. .,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
| | | | - Hussam Assiri
- King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Reem Alkhodair
- Muhammad ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed A Hussein
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Kingdom of Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
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Edmonds CJ, Harte N, Gardner M. How does drinking water affect attention and memory? The effect of mouth rinsing and mouth drying on children's performance. Physiol Behav 2018; 194:233-238. [DOI: 10.1016/j.physbeh.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 05/16/2018] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
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Villiger M, Stoop R, Vetsch T, Hohenauer E, Pini M, Clarys P, Pereira F, Clijsen R. Evaluation and review of body fluids saliva, sweat and tear compared to biochemical hydration assessment markers within blood and urine. Eur J Clin Nutr 2018; 72:69-76. [PMID: 28853743 PMCID: PMC5765170 DOI: 10.1038/ejcn.2017.136] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/22/2017] [Accepted: 07/25/2017] [Indexed: 11/29/2022]
Abstract
Evaluating and testing hydration status is increasingly requested by rehabilitation, sport, military and performance-related activities. Besides commonly used biochemical hydration assessment markers within blood and urine, which have their advantages and limitations in collection and evaluating hydration status, there are other potential markers present within saliva, sweat or tear. This literature review focuses on body fluids saliva, sweat and tear compared to blood and urine regarding practicality and hydration status influenced by fluid restriction and/or physical activity. The selected articles included healthy subjects, biochemical hydration assessment markers and a well-described (de)hydration procedure. The included studies (n=16) revealed that the setting and the method of collecting respectively accessing body fluids are particularly important aspects to choose the optimal hydration marker. To obtain a sample of saliva is one of the simplest ways to collect body fluids. During exercise and heat exposures, saliva composition might be an effective index but seems to be highly variable. The collection of sweat is a more extensive and time-consuming technique making it more difficult to evaluate dehydration and to make a statement about the hydration status at a particular time. The collection procedure of tear fluid is easy to access and causes very little discomfort to the subject. Tear osmolarity increases with dehydration in parallel to alterations in plasma osmolality and urine-specific gravity. But at the individual level, its sensitivity has to be further determined.
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Affiliation(s)
- M Villiger
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
- THIM University of Applied Sciences, Landquart, Switzerland
| | - R Stoop
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
| | - T Vetsch
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
| | - E Hohenauer
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
- THIM University of Applied Sciences, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Pini
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
| | - P Clarys
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - F Pereira
- Faculty of Medicine, Imperial College London, London, Great Britain
- CSEM Centre Suisse d’Electronique et de Microtechnique SA, Landquart, Switzerland
| | - R Clijsen
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland
- THIM University of Applied Sciences, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Rosinger AY, Lawman HG, Akinbami LJ, Ogden CL. The role of obesity in the relation between total water intake and urine osmolality in US adults, 2009-2012. Am J Clin Nutr 2016; 104:1554-1561. [PMID: 27935519 PMCID: PMC7392307 DOI: 10.3945/ajcn.116.137414] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 10/05/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Adequate water intake is critical to physiologic and cognitive functioning. Although water requirements increase with body size, it remains unclear whether weight status modifies the relation between water intake and hydration status. OBJECTIVE We examined how the association between water intake and urine osmolality, which is a hydration biomarker, varied by weight status. DESIGN NHANES cross-sectional data (2009-2012) were analyzed in 9601 nonpregnant adults aged ≥20 y who did not have kidney failure. Weight status was categorized with the use of body mass index on the basis of measured height and weight (underweight or normal weight, overweight, and obesity). Urine osmolality was determined with the use of freezing-point depression osmometry. Hypohydration was classified according to the following age-dependent formula: ≥831 mOsm/kg - [3.4 × (age - 20 y)]. Total water intake was determined with the use of a 24-h dietary recall and was dichotomized as adequate or low on the basis of the Institute of Medicine's adequate intake recommendations for men and women (men: ≥3.7 or <3.7 L; nonlactating women: ≥2.7 or <2.7 L; lactating women: ≥3.8 or <3.8 L for adequate or low intakes, respectively). We tested interactions and conducted linear and log-binomial regressions. RESULTS Total water intake (P = 0.002), urine osmolality (P < 0.001), and hypohydration prevalence (P < 0.001) all increased with higher weight status. Interactions between weight status and water intake status were significant in linear (P = 0.005) and log-binomial (P = 0.015) models, which were then stratified. The prevalence ratio of hypohydration between subjects with adequate water intake and those with low water intake was 0.56 (95% CI: 0.43, 0.73) in adults who were underweight or normal weight, 0.67 (95% CI: 0.57, 0.79) in adults who were overweight, and 0.78 (95% CI: 0.70, 0.88) in adults who were obese. CONCLUSION On a population level, obesity modifies the association between water intake and hydration status.
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Affiliation(s)
- Asher Y Rosinger
- Epidemic Intelligence Service, Atlanta, GA;
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD; and
| | - Hannah G Lawman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD; and
| | - Lara J Akinbami
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD; and
- Public Health Service, Rockville, MD
| | - Cynthia L Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD; and
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Edmonds CJ, Crosbie L, Fatima F, Hussain M, Jacob N, Gardner M. Dose-response effects of water supplementation on cognitive performance and mood in children and adults. Appetite 2016; 108:464-470. [PMID: 27825957 DOI: 10.1016/j.appet.2016.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Water supplementation has been found to facilitate visual attention and short-term memory, but the dose required to improve performance is not yet known. We assessed the dose response effect of water on thirst, mood and cognitive performance in both adults and children. Participants were offered either no water, 25 ml or 300 ml water to drink. Study 1 assessed 96 adults and in Study 2, data are presented from 60 children aged 7-9 years. In both studies, performance was assessed at baseline and 20 min after drinking (or no drink); on thirst and mood scales, letter cancellation and a digit span test. For both children and adults, a large drink (300 ml) was necessary to reduce thirst, while a small drink (25 ml) was sufficient to improve visual attention (letter cancellation). In adults, a large drink improved digit span, but there was no such effect in children. In children, but not adults, a small drink resulted in increased thirst ratings. Both children and adults show dose-response effects of drinking on visual attention. Visual attention is enhanced by small amounts of fluid and appears not to be contingent on thirst reduction. Memory performance may be related to thirst, but differently for children and adults. These contrasting dose-response characteristics could imply cognitive enhancement by different mechanisms for these two domains.
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Affiliation(s)
- Caroline J Edmonds
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK.
| | - Laura Crosbie
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
| | - Fareeha Fatima
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
| | - Maryam Hussain
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
| | - Nicole Jacob
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
| | - Mark Gardner
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
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