Mild dehydration and cycling performance during 5-kilometer hill climbing

Perceived dehydration impairs endurance cycling performance in the heat in active males

Dehydration of >3 % body mass impairs endurance performance irrespective of the individual's knowledge of their hydration status, but whether knowledge of hydration status influences performance at lower levels of dehydration is unknown. This study examined whether perception of hydration status influenced endurance performance. After familiarisation, nine active males (age 25 ± 2 y, V̇O2peak 52.5 ± 9.1 mL kg min-1) completed two randomised trials at 34 °C. Trials involved an intermittent exercise preload (8 × 10 min cycling/5 min rest), followed by a 15 min all-out cycling performance test. During the preload in both trials, water was ingested orally every 10 min (0.3 mL kg body mass-1), with additional water infused into the stomach via gastric feeding tube to produce dehydration of ∼1.5 % body mass pre-performance test. Participants were told intra-gastric infusion was manipulated to produce euhydration (0 % dehydration; Perceived-EUH) or dehydration (2 % dehydration; Perceived-DEH) pre-performance test, which was told to them pre-preload and confirmed after body mass measurement pre-performance test. Body mass loss during the preload (Perceived-EUH 1.6 ± 0.2 %, Perceived-DEH 1.7 ± 0.2 %; P = 0.459), heart rate, gastrointestinal temperature and RPE (P ≥ 0.110) were not different between trials. Thirst was greater at the end of the preload and performance test in Perceived-DEH (P ≤ 0.040). Work completed during the performance test was 5.6 ± 6.1 % lower in Perceived-DEH (187.4 ± 37.0 kJ vs. 176.9 ± 36.0 kJ; P = 0.038). These results suggest that at lower levels of dehydration (<2 % body mass), an individual's perception of their hydration status could impair their performance, as well as their thirst perception.

Sweat Characteristics and Fluid Balance Responses During Two Heat Training Camps in Elite Female Field Hockey Players

We examined the sweat characteristics and fluid balance of elite female field hockey players during two heat training camps. Fourteen elite female field hockey players from the Australian national squad participated in two heat training camps held ∼6 months apart, following winter- (Camp 1) and summer-based training (Camp 2). Daily waking body mass (BM) and urine specific gravity (USG) were collected, along with several markers of sweat and fluid balance across two matches per camp. There was a 19% mean reduction in estimated whole-body sweat sodium concentration from Camp 1 (45.8 ± 6.5 mmol/L) to Camp 2 (37.0 ± 5.0 mmol/L; p < .001). Waking urine specific gravity ≥ 1.020 was observed in 31% of samples, with no significant differences in mean urine specific gravity or BM between camps (p > .05), but with substantial interindividual variation. Intramatch sweat rates were high (1.2-1.8 L/hr), with greater BM losses in Camp 1 (p = .030), resulting in fewer players losing ≥2% BM in Camp 2 (0%-8%), as compared with Camp 1 (36%-43%; p = .017). Our field data suggest that elite female field hockey players experience substantial sweat losses during competition in the heat regardless of the season. In agreement with previous findings, we observed substantial interindividual variation in sweat and hydration indices, supporting the use of individualized athlete hydration strategies.

Hydration and Performance in Young Triathletes During a Competition in Tropical Climate

PURPOSE

We examined fluid intake, the relation between body mass (BM) loss and performance, and core temperature in young triathletes during a competition in tropical climate.

METHODS

Fluid intake and pre and post BM were measured in 35 adolescent athletes, and core temperature was measured in one female and one male.

RESULTS

Mean urine specific gravity (1.024 [0.007]) indicated that athletes were in suboptimal state of hydration upon waking. Race time was 73.2 (8.0) minutes. BM decreased by 0.6 (0.3) kg (P < .05). Fluid intake (528.5 [221.6] mL) replaced 47% of the fluid loss (1184.9 [256.4] mL) and was higher during run (11.5 [6.6] mL·min-1) compared to bike (7.3 [3.1] mL·min-1), P < .01. Loss in BM was ≥1.0% in 66% and ≥1.5% in 29% of the athletes. Males showed a moderate association between percentage loss in BM and finishing time (r = -.52), higher sweat rates (1.0 [0.3] L·h-1), and faster times (69.4 [7.5] min; P < .05). Core temperature rose to 40.1 °C in the female and 39.6 °C in the male.

CONCLUSION

Young triathletes competing in a hot/humid climate became mildly to moderately dehydrated and hyperthermic even when water and sports drinks were available but did not show symptoms of heat illness.

Short hydration education video and hiker fluid selection and consumption at trails, a non-randomized quasi-experimental field study

Background: Education may improve hiker safety on trails. Aim: To investigate the impact of an educational video on hiker fluid selection and fluid consumption in a hot environment. Methods: Quasi-experimental field study at hiking trails in which the intervention group (INT) viewed a three-minute hydration education video, whereas the control group (CON) did not. Before the hike, all hikers were asked if they wanted to select extra fluid, which was provided by the research team. Results: A total of n = 97 hikers participated in the study, with n = 56 in INT (32 male) and n = 41 in CON (25 male). Despite absolute differences in environmental conditions, the differences fell within the same WBGT category. The total amount of fluid brought to the trails by participants was different between INT: 904 (503-1758) mL and CON: 1509 (880-2176) mL (P = 0.006), but participants in the INT group selected extra fluid (41%; n = 23) significantly more often when compared with participants in the CON group (7%; n = 3; P < 0.001). As a result, there was no difference in the amount of fluid brought on the trail between INT: 1047 (611-1936) mL and CON: 1509 (932-2176) mL (P = 0.069), nor for fluid consumption between INT: 433 (289-615) mL/h and CON: 489 (374-719) mL/h (P = 0.18). Conclusions and Implications: A 3-min educational video may encourage hikers to select additional fluid before the start of their hike but does not appear to increase fluid intake.

A randomized, cross-over trial assessing effects of beverage sodium concentration on plasma sodium concentration and plasma volume during prolonged exercise in the heat

PURPOSE

This study assessed whether increasing sodium in a sports drink above that typical (~ 20 mmol L^-1) affects plasma sodium and volume responses during prolonged exercise in the heat.

METHODS

Endurance trained males (N = 11, 36 ± 14 y, 75.36 ± 5.30 kg, [Formula: see text]O_2max 60 ± 3 mL min^-1 kg^-1) fulfilled requirements of the study including one 1-h exercise pre-trial, to estimate fluid losses (to prescribe fluid intake), and two, experimental trials (3-h or until tolerance), in random order, cycling (55% [Formula: see text]O_2max, 34 °C, 65% RH). Beverages contained 6% carbohydrate and either 21 mmol L^-1 (Low Na⁺) or 60 mmol L^-1 sodium (High Na⁺). Analyses included linear mixed models and t-tests.

RESULTS

Cycling time was similar 176 ± 9 min (Low Na⁺); 176 ± 7 min (High Na⁺). Fluid intake was 1.12 ± 0.19 L h^-1; 1.14 ± 0.21 L h^-1, resp. Body mass change was - 0.53 ± 0.40%;  - 0.30 ± 0.45%, resp. Sodium intake was 69 ± 12 mmol; 201 ± 40 mmol, resp. Plasma sodium concentration was greater in High Na⁺ than Low Na⁺ (p < 0.001); decreasing in Low Na⁺ (- 1.5 ± 2.2 mmol L^-1), increasing in High Na⁺ (0.8 ± 2.4 mmol L^-1) (p = 0.048, 95% CI [- 4.52, - 0.02], d = 0.99). Plasma volume decreased in Low Na⁺ (- 2 ± 2%) but remained unchanged in High Na⁺ (0 ± 3%) (p = 0.01, 95% CI [- 3.2, - 0.5], d = 0.80).

CONCLUSIONS

When conducting prolonged exercise in the heat, those who fully hydrate would benefit by increased sodium content of the beverage by improved plasma volume and sodium maintenance. Australian New Zealand Clinical Trials Registry (ACTRN12616000239460) 22/02/16.

Effects of Heat Acclimation Following Heat Acclimatization on Whole Body Heat Exchange in Trained Endurance Athletes

The purpose of this study was to examine the changes in metabolic heat production (Hprod), evaporative heat loss (Hevap), and dry heat loss (Hdry), following heat acclimatization (HAz) and heat acclimation (HA). Twenty-two male endurance athletes (mean ± standard deviation; age, 37 ± 12 y; body mass, 73.4 ± 8.7 kg; height, 178.7 ± 6.8 cm; and VO2max, 57.1 ± 7.2 mL·kg−1·min−1) completed three trials (baseline; post-HAz; and post-HA), which consisted of 60 min steady state exercise at 59 ± 2% velocityVO2max in the heat (ambient temperature [Tamb], 35.2 ± 0.6 °C; relative humidity [%rh] 47.5 ± 0.4%). During the trial, VO2 and RER were collected to calculate Hprod, Hevap, and Hdry. Following the baseline trial, participants completed self-directed outdoor summer training followed by a post-HAz trial. Then, five days of HA were completed over eight days in the heat (Tamb, 38.7 ± 1.1 °C; %rh, 51.2 ± 2.3%). During the HA sessions, participants exercised to maintain hyperthermia (38.50 °C and 39.75 °C) for 60 min. Then, a post-HA trial was performed. There were no differences in Hprod between the baseline (459 ± 59 W·m−2), post-HAz (460 ± 61 W·m−2), and post-HA (464 ± 55 W·m−2, p = 0.866). However, Hevap was significantly increased post-HA (385 ± 84 W·m−2) compared to post-HAz (342 ± 86 W·m−2, p = 0.043) and the baseline (332 ± 77 W·m−2, p = 0.037). Additionally, Hdry was significantly lower at post-HAz (125 ± 8 W·m−2, p = 0.013) and post-HA (121 ± 10 W·m−2, p < 0.001) compared to the baseline (128 ± 7 W·m−2). Hdry at post-HA was also lower than post-HAz (p = 0.049). Hprod did not change following HAz and HA. While Hdry was decreased following HA, the decrease in Hdry was smaller than the increases in Hevap. Adaptations in body heat exchange can occur by HA following HAz.

Acute Kidney Injury Biomarkers and Hydration Outcomes at the Boston Marathon

The purpose of our field study was to investigate the effects of running the Boston Marathon on acute kidney injury (AKI) biomarkers. We hypothesized that biomarker values would be elevated immediately post-marathon but would resolve in the 24-h post-marathon. Secondarily, we sought to identify sex differences related to renal stress. Participants were 65 runners who completed the Boston Marathon (46 ± 9 years, 65.4 ± 10.8 kg). Urine samples were collected at three different time points (pre-marathon, post-marathon, and 24-h post-marathon). Blood samples were collected post-marathon and 24-h post-marathon. Urine specific gravity (USG) and AKI biomarkers were evaluated. Pre-marathon USG (1.012 ± 0.007) was significantly less than post-marathon (1.018 ± 0.008) and 24-h post-marathon (1.020 ± 0.009; P < 0.001). Male USG (1.024 ± 0.009) was significantly greater 24-h post-marathon than females (1.017 ± 0.008; P = 0.019). Urinary neutrophil gelatinase-associated lipocalin values were significantly greater over time (P < 0.001), and there was a main effect of sex with female urinary creatinine (_UCr) greater than males at all three time points (P = 0.040). Post-marathon_UCr (366.24 ± 295.16 mg/dl) was significantly greater than pre-marathon (206.65 ± 145.28.56 mg/dl; p < 0.001) and 24-h post-marathon was significantly lower than other time-points (93.90 ± 125.07 mg/dl; P < 0.001). Female_UCr values were significantly greater than males 24-h post-marathon (P < 0.001). There was no difference in serum cystatin C (_SCys) values post- or 24-h post-marathon (P = 0.178). Serum creatinine (_SCr) significantly decreased between post-marathon and 24-h post-marathon, (P < 0.001). We can infer that the characteristics unique to the Boston Marathon may have attributed to prolonged elevations in AKI biomarkers. Sex differences were observed during the Boston Marathon warranting further investigation.

Effects of Heat Acclimatization, Heat Acclimation, and Intermittent Exercise Heat Training on Time-Trial Performance

BACKGROUND

The purpose of this study was to investigate effects of heat acclimatization (HAz) followed by heat acclimation (HA), and intermittent heat training (IHT) on time-trial performance.

HYPOTHESIS

Time-trial performance will improve after HA and will further improve with twice a week of IHT.

STUDY DESIGN

Interventional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 26 male athletes (mean ± SD; age, 35 ± 12 years; body mass, 72.8 ± 8.9 kg; peak oxygen consumption [VO_2peak], 57.3 ± 6.7 mL·kg^-1·min^-1) completed five 4-km time trials (baseline, post-HAz, post-HA, post-IHT4, post-IHT8) in the heat (ambient temperature, 35.4°C ± 0.3°C; relative humidity, 46.7% ± 1.2%) on a motorized treadmill. After baseline time trial, participants performed HAz (109 ± 10 days) followed by post-HAz time trial. Then, participants completed 5 days of HA, which involved exercising to induce hyperthermia (38.50°C-39.75°C) for 60 minutes. Participants were then divided into 3 groups and completed IHT either twice per week (IHT_MAX), once per week (IHT_MIN), or not at all (IHT_CON) over an 8-week period. The exercise used for the IHT matched the HA. Four-kilometer time trials were performed after 4 weeks (post-IHT4) and 8 weeks of IHT (post-IHT8).

RESULTS

Time trial was faster in post-HA (17.98 ± 2.51 minutes) compared with baseline (18.61 ± 3.06 minutes; P = 0.037) and post-HAz (18.66 ± 3.12 minutes; P = 0.023). Percentage change in time trial was faster in IHT_MAX (-3.9% ± 5.2%) compared with IHT_CON (11.5% ± 16.9%) (P = 0.020) and approached statistical significance with large effect (effect size = 0.96) compared with IHT_MIN (1.6% ± 6.2%; P = 0.059) at post-IHT8. Additionally, IHT_MAX (-2.2% ± 4.2%) was faster than IHT_CON (3.6% ± 6.9%) (P = 0.05) at post-IHT4.

CONCLUSION

These results indicate that HA after HAz induces additional improvement in time-trial performance. IHT twice per week shows improvement after 8 weeks, while once per week maintains performance for 8 weeks. No IHT results in a loss of adaptations after 4 weeks and even greater losses after 8 weeks.

CLINICAL RELEVANCE

HA after HAz improves time-trial performance, twice a week of IHT improves performance further, and once a week of IHT maintains performance for at least 8 weeks.

Relationships Between WUT (Body Weight, Urine Color, and Thirst Level) Criteria and Urine Indices of Hydration Status

BACKGROUND

A Venn diagram consisting of percentage body mass loss, urine color, and thirst perception (weight, urine, thirst [WUT]) has been suggested as a practical method to assess hydration status. However, no study to date has examined relationships between WUT and urine hydration indices. Thus, the purpose of this study was to investigate relationships between urine specific gravity, urine osmolality, and the WUT criteria.

HYPOTHESIS

Urine specific gravity and urine osmolality indicate hypohydration when the WUT criteria demonstrate hypohydration (≥2 markers).

STUDY DESIGN

Laboratory cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 22 women (mean ± SD; age, 20 ± 1 years; mass, 65.4 ± 12.6 kg) and 21 men (age, 21 ± 1 years; body mass, 78.7 ± 14.6 kg) participated in this study. First morning body mass, urine color, urine specific gravity, urine osmolality, and thirst level were collected for 10 consecutive days in a free-living situation. Body mass loss >1%, urine color >5, and thirst level ≥5 were used as the dehydration thresholds. The number of markers that indicated dehydration levels were counted and categorized into either 3, 2, 1, or 0 WUT markers that indicated dehydration. One-way analysis of variance with Tukey pairwise comparisons was used to assess the differences in urine specific gravity and urine osmolality between the different number of WUT markers.

RESULTS

Urine specific gravity in 3 WUT markers (mean ± SD [effect size], 1.021 ± 0.007 [0.57]; P = 0.025) and 2 WUT markers (1.019 ± 0.010 [0.31]; P = 0.026) was significantly higher than 1 WUT marker (1.016 ± 0.009). Urine mosmolality in 2 WUT markers (705 ± 253 mOsmol [0.43]; P = 0.018) was significantly higher than 1 WUT (597 ± 253 mOsmol). Meeting at least 2 WUT markers resulted in sensitivities of 0.652 (2 WUT criteria met) and 0.933 (3 WUT criteria met) to detect urine osmolality >700 mOsmol.

CONCLUSION

These results suggest that when 3 WUT markers are met, urine specific gravity and urine osmolality were greater than euhydration cutoff points. The WUT criterion is a useful tool to use in field settings to assess hydration status when first morning urine sample was used.

CLINICAL RELEVANCE

Athletes, coaches, sports scientists, and medical professionals can use WUT criteria to monitor dehydration with reduced cost and time.

Hydration Status in Adolescent Alpine Skiers During a Training Camp

Maintaining euhydration is important for optimal health, performance and recovery, but can be challenging for alpine skiers when training in a relatively cold but dry environment. This study aimed to evaluate hydration status, fluid loss and fluid intake in adolescent alpine skiers during a training camp. Twelve athletes aged 14.3 ± 0.9 years volunteered to participate in the study. Athletes resided at an altitude of 1600 m and trained between 1614 and 2164 m. During eight consecutive days, urine specific gravity was measured before each morning training session using a refractometer. Changes in body weight representing fluid loss and ad libitum fluid intake during each morning training session were assessed using a precision scale. Mean pre-training urine specific gravity remained stable throughout the training camp. Individual values ranged between 1.010 and 1.028 g/cm³with 50 to 83% of athletes in a hypohydrated state (urine specific gravity ≥ 1.020 g/cm³). Mean training induced fluid loss remained stable throughout the training camp (range -420 to -587 g) with individual losses up to 1197 g (-3.5%). Fluid intake was significantly lower than fluid loss during each training session. To conclude, urine specific gravity values before training indicated insufficient daily fluid intake in more than half of the athletes. Furthermore, fluid intake during training in adolescent alpine skiers was suboptimal even when drinks were provided ad libitum. Coaches and athletes should be encouraged to carefully monitor hydration status and to ensure that alpine skiers drink sufficiently during and in between training sessions.

Contribution of Dietary Composition on Water Turnover Rates in Active and Sedentary Men

Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated with hypohydration. There is currently limited research investigating the interrelationship of fluid balance, dietary intake and activity level when considering body water turnover. Therefore, this study investigates whether dietary composition and energy expenditure influences body water turnover. In our methodology, thirty-eight males (19 sedentary and 19 physically active) had their total body water and water turnover measured via the isotopic tracer deuterium oxide. Simultaneous tracking of dietary intake (food and fluid) is carried out via dietary recall, and energy expenditure is estimated via accelerometery. Our results show that active participants display a higher energy expenditure, water intake, carbohydrate intake and fibre intake; however, there is no difference in sodium or alcohol intake between the two groups. Relative water turnover in the active group is significantly greater than the sedentary group (Mean Difference (MD) [95% CI] = 17.55 g·kg^-1·day^-1 [10.90, 24.19]; p = < 0.001; g[95% CI] = 1.70 [0.98, 2.48]). A penalised linear regression provides evidence that the fibre intake (p = 0.033), water intake (p = 0.008), and activity level (p = 0.063) predict participants' relative body water turnover (R²= 0.585). In conclusion, water turnover is faster in individuals undertaking regular exercise than in their sedentary counterparts, and is, in part, explained by the intake of water from fluid and high-moisture content foods. The nutrient analysis of the participant diets indicates that increased dietary fibre intake is also positively associated with water turnover rates. The water loss between groups also contributes to the differences observed in water turnover; this is partly related to differences in sweat output during increased energy expenditure from physical activity.

A Case-Series Observation of Sweat Rate Variability in Endurance-Trained Athletes

Adequate fluid replacement during exercise is an important consideration for athletes, however sweat rate (SR) can vary day-to-day. The purpose of this study was to investigate day-to-day variations in SR while performing self-selected exercise sessions to evaluate error in SR estimations in similar temperature conditions. Thirteen endurance-trained athletes completed training sessions in a case-series design 1x/week for a minimum 30 min of running/biking over 24 weeks. Body mass was recorded pre/post-training and corrected for fluid consumption. Data were split into three Wet-Bulb Globe Thermometer (WBGT) conditions: LOW (<10 °C), MOD (10–19.9 °C), HIGH (>20 °C). No significant differences existed in exercise duration, distance, pace, or WBGT for any group (p > 0.07). Significant differences in SR variability occurred for all groups, with average differences of: LOW = 0.15 L/h; MOD = 0.14 L/h; HIGH = 0.16 L/h (p < 0.05). There were no significant differences in mean SR between LOW-MOD (p > 0.9), but significant differences between LOW-HIGH and MOD-HIGH (p < 0.03). The assessment of SR can provide useful data for determining hydration strategies. The significant differences in SR within each temperature range indicates a single assessment may not accurately represent an individual’s typical SR even in similar environmental conditions.

Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies

A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.

Rehydration during Endurance Exercise: Challenges, Research, Options, Methods

During endurance exercise, two problems arise from disturbed fluid-electrolyte balance: dehydration and overhydration. The former involves water and sodium losses in sweat and urine that are incompletely replaced, whereas the latter involves excessive consumption and retention of dilute fluids. When experienced at low levels, both dehydration and overhydration have minor or no performance effects and symptoms of illness, but when experienced at moderate-to-severe levels they degrade exercise performance and/or may lead to hydration-related illnesses including hyponatremia (low serum sodium concentration). Therefore, the present review article presents (a) relevant research observations and consensus statements of professional organizations, (b) 5 rehydration methods in which pre-race planning ranges from no advanced action to determination of sweat rate during a field simulation, and (c) 9 rehydration recommendations that are relevant to endurance activities. With this information, each athlete can select the rehydration method that best allows her/him to achieve a hydration middle ground between dehydration and overhydration, to optimize physical performance, and reduce the risk of illness.

A Capacitive Sweat Rate Sensor for Continuous and Real-Time Monitoring of Sweat Loss

Individualized measurement of sweat loss under heat stress is important in assessing physical performance and preventing heat-related illness for athletes or individuals working in extreme environments. The objective of this work was to develop a low-cost and easy-to-fabricate wearable sensor that enables accurate real-time measurement of sweat rate. A capacitive-type sensor was fabricated from two conducting parallel plates, plastic insulating layers, and a central microfluidic channel formed by laser cutting a plastic film. The device has no microfabricated electrodes and is assembled using adhesive tape. Sensor accuracy was validated at different flow rates and confirmed using an equivalent circuit model of the device. On-body measurements demonstrate the feasibility of real-time measurements and show good agreement with values determined from a conventional sweat collection device.

Does Hypohydration Really Impair Endurance Performance? Methodological Considerations for Interpreting Hydration Research

The impact of alterations in hydration status on human physiology and performance responses during exercise is one of the oldest research topics in sport and exercise nutrition. This body of work has mainly focussed on the impact of reduced body water stores (i.e. hypohydration) on these outcomes, on the whole demonstrating that hypohydration impairs endurance performance, likely via detrimental effects on a number of physiological functions. However, an important consideration, that has received little attention, is the methods that have traditionally been used to investigate how hypohydration affects exercise outcomes, as those used may confound the results of many studies. There are two main methodological limitations in much of the published literature that perhaps make the results of studies investigating performance outcomes difficult to interpret. First, subjects involved in studies are generally not blinded to the intervention taking place (i.e. they know what their hydration status is), which may introduce expectancy effects. Second, most of the methods used to induce hypohydration are both uncomfortable and unfamiliar to the subjects, meaning that alterations in performance may be caused by this discomfort, rather than hypohydration per se. This review discusses these methodological considerations and provides an overview of the small body of recent work that has attempted to correct some of these methodological issues. On balance, these recent blinded hydration studies suggest hypohydration equivalent to 2–3% body mass decreases endurance cycling performance in the heat, at least when no/little fluid is ingested.

Effects of electrolyzed hydrogen water ingestion during endurance exercise in a heated environment on body fluid balance and exercise performance

Electrolyzed hydrogen water (EHW) is generated at a cathode. It contains many hydrogen molecules with high alkaline properties. The physiological effects of ingesting EHW during endurance exercise are unclear. The purpose of this study was to determine the effects of ingesting EHW during endurance exercise in a heated environment on body fluid balance and exercise performance. Twelve triathletes (20.0 ± 1.3 years, 171 ± 6 cm, 60.6 ± 3.9 kg, V̇O_2max 67.1 ± 3.8 mL/kg/min) performed pedaling exercise for 60 min at 65% of V̇O_2max consuming either purified water (CON trial) or EHW (EHW trial) and then conducted an incremental pedaling test. Blood parameters, tissue temperature, and respiratory variables were determined during 60 min of exercise. The time to exhaustion (TTE) during the incremental pedaling test was also determined. Body weights were 1.1 ± 0.4 kg lower after exercise, with no significant differences between trials. Plasma volume and serum osmolality and blood sodium and potassium concentrations significantly changed with exercise, but no significant differences were observed between trials. The pH, blood lactate and bicarbonate concentrations, and changes in skin and muscle temperature did not significantly differ between the two trials. Energy expenditure during exercise was significantly (P = 0.04) lower in the EHW trial (13.2 ± 0.5 kcal/min) than in the CON trial (13.7 ± 0.4 kcal/min). TTE did not significantly differ between the trials. In conclusion, EHW ingestion during endurance exercise in a heated environment decreased energy expenditure but did not affect body fluid balance or exercise performance. Abbreviations: CON: control trial; CV: coefficient of variation; EHW: electrolyzed hydrogen water; HR: heart rate; RPE: rating of perceived exertion; SE: standard error; TP: total protein; TTE: time to exhaustion.

Mild dehydration following voluntary water intake reduction does not affect anaerobic power performance

BACKGROUND

Dehydration is common among athletes. The negative impact of dehydration on aerobic performance is well characterized. However, little is known about the effect of dehydration on anaerobic performance particularly when dehydration results from insufficient water intake, not water loss due to body temperature regulation. The purpose of this study was to examine the effect of dehydration on anaerobic performance following voluntary water intake reduction.

METHODS

Fifteen healthy adults completed two exercise sessions, euhydrated (EUD) and dehydrated (DEH). Sessions consisted of baseline anthropometric and blood lactate measurement followed by a 30-second Wingate test and three vertical jump trials to measure anaerobic performance. Additional blood lactate measurements were taken immediately and at 5, 10, and 15 minutes after taking the Wingate test.

RESULTS

The dehydration protocol resulted in a reduction in body mass (EUD 69.1±17.2 kg, DEH 68.1±16.6 kg, P=0.039). The 30-s Wingate peak power (EUD 971±302 W, DEH 960±316 W, P=0.578) was not different between conditions, nor was the vertical jump height (EUH 26.4±4.5 cm, DEH 26.6±3.6 cm, P=0.778). Blood lactate (P<0.001) was elevated immediately following the 30-s Wingate test which remained throughout the trial. There were no differences in blood lactate between conditions.

CONCLUSIONS

Acute anaerobic power and exercise performance is not negatively affected by voluntary dehydration.

Performance Changes Following Heat Acclimation and the Factors That Influence These Changes: Meta-Analysis and Meta-Regression

Heat acclimation (HA) is the process of intentional and consistent exercise in the heat that results in positive physiological adaptations, which can improve exercise performance both in the heat and thermoneutral conditions. Previous research has indicated the many performance benefits of HA, however, a meta-analysis examining the magnitude of different types of performance improvement is absent. Additionally, there are several methodological discrepancies in the literature that could lead to increased variability in performance improvement following HA and no previous study has examined the impact of moderators on performance improvement following HA. Therefore, the aim of this study was two-fold; (1) to perform a meta-analysis to examine the magnitude of changes in performance following HA in maximal oxygen consumption (VO2max), time to exhaustion, time trial, mean power, and peak power tests; (2) to determine the impact of moderators on results of these performance tests. Thirty-five studies met the inclusion/exclusion criteria with 23 studies that assessed VO2max (n = 204), 24 studies that assessed time to exhaustion (n = 232), 10 studies that performed time trials (n = 101), 7 studies that assessed mean power (n = 67), and 10 papers that assessed peak power (n = 88). Data are reported as Hedge's g effect size (ES), and 95% confidence intervals (95% CI). Statistical significance was set to p < 0.05, a priori. The magnitude of change following HA was analyzed, with time to exhaustion demonstrating the largest performance enhancement (ES [95% CI], 0.86 [0.71, 1.01]), followed by time trial (0.49 [0.26, 0.71]), mean power (0.37 [0.05, 0.68]), VO2max (0.30 [0.07, 0.53]), and peak power (0.29 [0.09, 0.48]) (p < 0.05). When all of the covariates were analyzed as individual models, induction method, fitness level, heat index in time to exhaustion (coefficient [95% CI]; induction method, -0.69 [-1.01, -0.37], p < 0.001; fitness level, 0.04 [0.02, 0.06], p < 0.001; heat index, 0.04 [0.02, 0.07], p < 0.0001) and induction length in mean power (coefficient [95% CI]; induction length 0.15 [0.05, 0.25], p = 0.002) significantly impacted the magnitude of change. Sport scientists and researchers can use the findings from this meta-analysis to customize HA induction. For time to exhaustion improvements, HA implementation should focus on induction method and baseline fitness, while the training and recovery balance could lead to optimal time trial performance.

Observational study of the effects of upper respiratory tract infection on hydration status

Background

A frequent treatment recommendation during acute respiratory infection is to increase fluid intake. This is the first study to investigate whether upper respiratory tract infections (URTIs) such as common cold can lead to dehydration, as commonly believed by the public.

Methods

This was an exploratory, noninterventional, observational, single-center study. Subjects made 2 visits to a UK study center for assessments of dehydration, once during URTI and then 2–3 weeks later when fully recovered. The primary endpoint was a comparison of serum osmolality during vs after URTI. Complete blood count, serum urea, serum electrolytes, urine parameters (eg, osmolality, specific gravity, color), body weight/BMI, subjective assessment of thirst, and physician assessment of dehydration were additional outcomes. Only descriptive statistics and shift tables were used.

Results

Fifty-five otherwise healthy adults with moderate to severe URTI of < 120 h in duration were enrolled (63.6% female, 94.5% white, mean [SD] age 21.0 [6.8] years). There was no evidence of dehydration based on serum osmolality (mean [SD] 287.63 [4.83] mosm/kg during URTI; 288.60 [5.99] mosm/kg after recovery). With only a few exceptions, complete blood count, serum urea, serum electrolytes, urine specific gravity, urine color, and physician ratings of hydration remained stable. Body weight decreased > 1% in 34.0% of subjects and increased > 1% in 17.0% between visits, with similar changes in BMI. Urine osmolality varied: 14 subjects showed a decrease and 5 showed an increase, resulting in a higher mean [SD] urine osmolality during URTI (700.50 [231.59] vs 618.47 [320.29] mosm/kg). Subjects perceived greater thirst during URTI.

Conclusions

In this pilot observational study, we found no evidence that URTIs such as common cold are associated with dehydration, contrary to popular belief.

Self-Selected Pacing during a 24 h Track Cycling World Record

The present case study analyzed the pacing in a self-paced world record attempt during a 24 h track cycling event by the current world record holder. The cyclist completed 3767 laps on a 250 m long cycling track and covered a total distance of 941.873 km, breaking the existing world record by 37.99 km. The average cycling speed was 39.2 ± 1.9 km/h (range 35.5–42.8 km/h) and the power output measured was 214.5 ± 23.7 W (range 190.0–266.0 W) during the 24 h of cycling. We found a positive pacing result with negative correlations between cycling speed (r = −0.73, p < 0.001), power output (r = −0.66, p < 0.001), and laps per hour (r = −0.73, p < 0.001) and the covered distance. During the 24 h, we could identify four different phases: the first phase lasting from the start till the fourth hour with a relatively stable speed; the second phase from the fourth till the ninth hour, characterized by the largest decrease in cycling speed; the third phase from the ninth hour till the 22nd hour, showing relatively small changes in cycling speed; and the last phase from the 22nd hour till the end, presenting a final end spurt. The performance in the 24 h track cycling was 45.577 km better than in the 24 h road cycling, where the same athlete cycled slower but with higher power output. In summary, the current world-best ultracyclist covered more kilometers with less power output during the world record 24 h track cycling than during his world record 24 h road cycling. This was most probably due to the more favorable environmental conditions in the velodrome, which has no wind and stable temperatures.

Hydration Status and Cardiovascular Function

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.

Hydration Status and Fluid Needs of Division I Female Collegiate Athletes Exercising Indoors and Outdoors

The purpose was to determine differences in acute and chronic hydration status in female student-athletes (n = 40) practicing in moderate, dry conditions (17-25 °C, 30-57% humidity) indoors and outdoors. Body weight and urine samples were recorded before and after exercise as well as fluid intake. Sweat rates expressed as median and interquartile range did not differ, but fluid intake was significantly higher during indoor (0.64 [0.50, 0.83] L/h) vs. outdoor conditions (0.51 [0.43, 0.63] L/h), p = 0.001. Fluid intake compensated for indoor sweat rate but not outdoors. When exercising indoors, 49% of the student-athletes reported urine specific gravity (USG) values >1.020, and 24% of the day after morning samples were scored ≥4 on the color chart rating. The percentages increased to 58% and 31%, respectively, when exercising outdoors (p > 0.05). Thus, fluid intake was higher indoors vs. outdoors but sweat rate did not differ among athletes. Yet, chronic hydration status was impaired in more than 50% of the student-athletes with a discrepancy between USG scores and urine color scores identifying underhydration. This suggest that 24-h fluid intake should be taken into account and that hydration protocols may need to be tailored individually based on urine USG values. Practice location (indoors vs. outdoors) may further complicate hydration protocols.

Blinded and unblinded hypohydration similarly impair cycling time trial performance in the heat in trained cyclists

Knowledge of hydration status may contribute to hypohydration-induced exercise performance decrements; therefore, this study compared blinded and unblinded hypohydration on cycling performance. Fourteen trained, nonheat-acclimated cyclists (age: 25 ± 5 yr; V̇o2peak: 63.3 ± 4.7 ml·kg−1·min−1; cycling experience: 6 ± 3 yr) were pair matched to blinded (B) or unblinded (UB) groups. After familiarization, subjects completed euhydrated (B-EUH; UB-EUH) and hypohydrated (B-HYP; UB-HYP) trials in the heat (31°C); 120-min cycling preload (50% Wpeak) and a time trial (~15 min). During the preload of all trials, 0.2 ml water·kg body mass−1 was ingested every 10 min, with additional water provided during EUH trials to match sweat losses. To blind the B group, a nasogastric tube was inserted in both trials and used to provide water in B-EUH. The preload induced similar ( P = 0.895) changes in body mass between groups (B-EUH: −0.6 ± 0.5%; B-HYP: −3.0 ± 0.5%; UB-EUH: −0.5 ± 0.3%; UB-HYP −3.0 ± 0.3%). All variables responded similarly between B and UB groups ( P ≥ 0.558), except thirst ( P = 0.004). Changes typical of hypohydration (increased heart rate, rating of perceived exertion, gastrointestinal temperature, serum osmolality and thirst, and decreased plasma volume; P ≤ 0.017) were apparent in HYP by 120 min. Time trial performance was similar between groups ( P = 0.710) and slower ( P ≤ 0.013) with HYP for B (B-EUH: 903 ± 89 s; B-HYP: 1,008 ± 121 s; −11.4%) and UB (UB-EUH: 874 ± 108 s; UB-HYP: 967 ± 170 s; −10.1%). Hypohydration of ~3% body mass impairs time trial performance in the heat, regardless of knowledge of hydration status.

NEW & NOTEWORTHY This study demonstrates, for the first time, that knowledge of hydration status does not exacerbate the negative performance consequences of hypohydration when hypohydration is equivalent to ~3% body mass. This is pivotal for the interpretation of the many previous studies that have not blinded subjects to their hydration status and suggests that these previous studies are not likely to be confounded by the overtness of the methods used to induce hypohydration.

Mild hypohydration impairs cycle ergometry performance in the heat: A blinded study

The aim of the present study was to observe the effect of mild hypohydration on exercise performance with subjects blinded to their hydration status. Eleven male cyclists (weight 75.8 ± 6.4 kg, VO_2peak : 64.9 ± 5.6 mL/kg/min, body fat: 12.0 ± 5.8%, Power_max : 409 ± 40 W) performed three sets of criterium-like cycling, consisting of 20-minute steady-state cycling (50% peak power output), each followed by a 5-km time trial at 3% grade. Following a familiarization trial, subjects completed the experimental trials, in counter-balanced fashion, on two separate occasions in dry heat (30°C, 30% rh) either hypohydrated (HYP) or euhydrated (EUH). In both trials, subjects ingested 25 mL of water every 5 minutes during the steady-state and every 1 km of the 5-km time trials. In the EUH trial, sweat losses were fully replaced via intravenous infusion of isotonic saline, while in the HYP trial, a sham IV was instrumented. Following the exercise protocol, the subjects' bodyweight was changed by -0.1 ± 0.1% and -1.8 ± 0.2% for the EUH and HYP trial, respectively (P < 0.05). During the second and third time trials, subjects averaged higher power output (309 ± 5 and 306 ± 5 W) and faster cycling speed (27.5 ± 3.0 and 27.2 ± 3.1 km/h) in the EUH trial compared to the HYP trial (Power: 287 ± 4 and 276 ± 5 W, Speed: 26.2 ± 2.9 and 25.5 ± 3.3 km/h, all P < 0.05). Core temperature (T_re ) was higher in the HYP trial throughout the third steady-state and 5-km time trial (P < 0.05). These data suggest that mild hypohydration, even when subjects were unaware of their hydration state, impaired cycle ergometry performance in the heat probably due to greater thermoregulatory strain.

Fluid balance and thermoregulatory responses of competitive triathletes

As little as 2% total body mass (BM) loss from sweat has been shown to compromise physiological functioning during prolonged exercise in the heat, subsequently compromising endurance performance.

PURPOSE

This observational study aims to describe the fluid balance and thermoregulatory responses of competitive triathletes racing at a major international competition in a cool environment.

METHODS

Fluid balance and thermoregulatory responses was measured in six (3 male, 3 female) national-level triathletes competing at the ITU World Triathlon Grand Finale in ambient temperatures of 19-20 °C (relative humidity (RH) ~55%). Dry, nude BM was recorded before and immediately following the race. Fluid intake was monitored throughout the race. Pre-race urine samples were measured for specific gravity (USG). Each athlete ingested a core temperature (Tc) pill 5 h prior to the event and was monitored before and after the race.

RESULTS

Three of six triathletes arrived at the race mildly dehydrated (USG 1.021,1.024,1.030). One of these athletes (1F) subsequently withdrew from the race providing no further data. Another athlete (1M) ended the race vomiting providing invalid hydration data. The four remaining competitors' sweat loss was on average 2.15 L (range: 1.65-2.80 L), while fluid intake was 0.66 L (0.50-0.85 L). A mean loss of 3.3% (2.2-4.5%) BM was recorded. Tc increased by 2.0 °C (1.1-2.9 °C) and 4/5 athletes' (2 M, 2 F) Tc exceeded 39 °C by race-end. Both female athletes self-reported feelings of heat-related exhaustion at the completion of the race.

CONCLUSIONS

Despite cool environmental conditions, elite triathletes lost ~3.3% BM, replacing only 33% of sweat losses, and achieved a Tc > 39 °C by race-end.

Total Water Intake and Urine Measures of Hydration in Adult Dogs Drinking Tap Water or a Nutrient-Enriched Water

Water intake and urine measures were evaluated in dogs offered tap water (TW) or a nutrient-enriched water (NW) supplement while fed dry food with ad libitum TW in a bucket. Baseline (day-7) urine specific gravity (USG) was analyzed from healthy, adult small breed dogs (n = 21; 2-11 years). Dogs (N = 16) were selected with ≥1.015 USG, then equally divided into 2 groups balanced for USG. Groups received either TW or NW in a bowl for 56 days. Dose for each dog was 0.5:1 water-to-calorie ratio (mL:kcal ME/d) from days 1-49 to evaluate sustained intake of a moderate volume, or 2:1 water-to-calorie ratio from days 50-56 to evaluate short-term intake of a large volume, based on baseline food calorie intake. Daily food calorie and total liquid intake (TLI; g/d; sum of NW or TW in a bowl and bucket water) was used to calculate weekly intake. USG was measured on days -7, 14, 42, 56. Calorie intake was not different (P > 0.49). A significant (P < 0.001) time-by-treatment interaction resulted for TLI with baseline similar between groups and no difference between weeks for the TW group. Following baseline, NW group had increased (P < 0.05) TLI every week, except for week 2 (P = 0.07). A significant (P < 0.002) time-by-treatment interaction resulted for USG, with baseline similar between groups and no difference between sampling days for the TW group (varied by ≤ 0.006 g/mL), whereas NW group was lower (P < 0.01) on days 42 (1.018 g/mL) and 56 (1.014 g/mL) vs. baseline (1.026 g/mL). This study indicates that all dogs offered the NW supplement increased their TLI and produced a more dilute urine, which suggests an improvement in indices associated with chronic hydration.

Working Dogs Drinking a Nutrient-Enriched Water Maintain Cooler Body Temperature and Improved Pulse Rate Recovery After Exercise

Exercise-related physiological changes were evaluated in hydrated, exercise-conditioned working dogs with free access to tap water (TW) with or without a nutrient-enriched water supplement (NW). Physiological samples and measures were collected before and after work-related field tasks in a warm and moderately humid ambient environment. In a cross-over design study, 12 dogs (age range 8-23 months) were evaluated on 3 separate occasions within each period with exercise bouts up to 30 min, on days -4, 3, and 11. Dogs were offered either ad libitum TW or portion-controlled NW daily plus ad libitum TW. Prior to and serially after exercise, pulse rate (PR), core (BT_core) and ear (BT_ear) temperature were recorded. Urine was collected first thing in the morning, whereas blood samples collected and body weight (BW) recorded pre- and immediately post exercise. Ambient temperature was above 21.7°C (71°F) and relative humidity ranged from 36 to 76%. Activity parameters, AM urine measures, post-exercise percent change of BW, resting PR and resting BT_core did not differ between treatment groups on any exercise day. At the completion of exercise, mean BT_core for all dogs ranged from 104.8 to 105.6°F. Immediate post-exercise BT_ear was always lower compared to BT_core and means ranged from 103.3 to 104.0°F. The effect of time was highly significant (P < 0.001) for both BT measures with both BT_core and BT_ear recovering to resting levels by 60 min post exercise. PR and several blood values showed a significant main effect of time. Over the recovery period, dogs in the NW group had lower mean BT_ear and PR by 0.6°F and 3.4 bpm, respectively. Daily ingestion of a NW in combination with free access to TW can reduce the post-exercise-related BT_core and BT_ear hyperthermia, and improve pulse rate recovery following exercise in this population of working dogs undergoing 30 min bout of exercise.

Hypohydration impairs endurance performance: a blinded study

The general scientific consensus is that starting exercise with hypohydration >2% body mass impairs endurance performance/capacity, but most previous studies might be confounded by a lack of subject blinding. This study examined the effect of hypohydration in a single blind manner using combined oral and intragastric rehydration to manipulate hydration status. After familiarization, seven active males (mean ± SD: age 25 ± 2 years, height 1.79 ± 0.07, body mass 78.6 ± 6.2, VO_2peak 48 ± 7 mL·kg·min^-1) completed two randomized trials at 34°C. Trials involved an intermittent exercise preload (8 × 15 min exercise/5 min rest), followed by a 15-min all-out performance test on a cycle ergometer. During the preload, water was ingested orally every 10 min (0.2 mL·kg body mass^-1). Additional water was infused into the stomach via a gastric feeding tube to replace sweat loss (EU) or induce hypohydration of ~2.5% body mass (HYP). Blood samples were drawn and thirst sensation rated before, during, and after exercise. Body mass loss during the preload was greater (2.4 ± 0.2% vs. 0.1 ± 0.1%; P < 0.001), while work completed during the performance test was lower (152 ± 24 kJ vs. 165 ± 22 kJ; P < 0.05) during HYP At the end of the preload, heart rate, RPE, serum osmolality, and thirst were greater and plasma volume lower during HYP (P < 0.05). These results provide novel data demonstrating that exercise performance in the heat is impaired by hypohydration, even when subjects are blinded to the intervention.

Effects of whey protein in carbohydrate-electrolyte drinks on post-exercise rehydration

The purpose of this study was to examine the effects of different amounts of whey protein in carbohydrate-electrolyte (CE) drinks on post-exercise rehydration. Ten males completed 5 trials in a randomised cross-over design. A 4-h recovery was applied after a 60-min run at 65% VO_2peak in each trial. During recovery, the participants ingested a high-carbohydrate CE drink (CE-H), a low-carbohydrate CE drink (CE-L), a high-whey-protein (33 g·L^-1) CE drink (CW-H), a medium-whey-protein (22 g·L^-1) CE drink (CW-M) or a low-whey-protein (15 g·L^-1) CE drink (CW-L) in a volume equivalent to 150% of their body mass (BM) loss. The drinks were provided in six equal boluses and consumed by the participants within 150 min in each trial. After exercise, a BM loss of 2.15% ± 0.05% was achieved. Urine production was less in the CW-M and CW-H trials during recovery, which induced a greater fluid retention in the CW-M (51.0% ± 5.7%) and CW-H (55.4% ± 3.8%) trials than in any other trial (p < .05). The plasma albumin content was higher in the CW-H trial than in the CE-H and CE-L trials at 2 h (p < .05) and 3 h (p < .01) during recovery. The aldosterone concentration was lower in the CE-H trial than in the CW-M and CW-H trials after recovery (p < .05). It is concluded that the rehydration was improved when whey protein was co-ingested with CE drinks during a 4-h recovery after a 60-min run. However, this additive effect was only observed when whey protein concentration was at least 22 g·L^-1 in the current study.

Prescribed Drinking Leads to Better Cycling Performance than Ad Libitum Drinking

Drinking ad libitum during exercise often leads to dehydration ranging from -1% to -3% of body weight.

PURPOSE

This article aimed to study the effect of a prescribed hydration protocol matching fluid losses on a simulated 30-km criterium-like cycling performance in the heat (31.6°C ± 0.5°C).

METHODS

Ten elite heat-acclimatized male endurance cyclists (30 ± 5 yr, 76.5 ± 7.2 kg, 1.81 ± 0.07 m, V˙O2peak = 61.3 ± 5.2 mL·min·kg, body fat = 10.5% ± 3.3%, Powermax = 392 ± 33 W) performed three sets of criterium-like cycling, which consisted of a 5-km cycling at 50% power max followed by a 5-km cycling all out at 3% grade (total 30 km). Participants rode the course on two separate occasions and in a counterbalanced order, during either ad libitum drinking (AD; drink water as much as they wished) or prescribed drinking (PD; drink water every 1 km to much fluid losses). To design the fluid intake during PD, participants performed a familiarization trial to calculate fluid losses.

RESULTS

After the exercise protocol, the cyclist dehydrated by -0.5% ± 0.3% and -1.8% ± 0.7% of their body weight for the PD and AD trial, respectively. The mean cycling speed for the third bout of the 5-km hill cycling was greater in the PD trial (30.2 ± 2.4 km·h) compared with the AD trial (28.8 ± 2.6 km·h) by 5.1% ± 4.8% (P < 0.05). Gastrointestinal, mean skin, and mean body temperatures immediately after the last hill climbing were greater in the AD compared with the PD trial (P < 0.05). Overall, sweat sensitivity during the three climbing bouts was lower in the AD (15.6 ± 5.7 g·W·m) compared with the PD trial (22.8 ± 3.4 g·W·m, P < 0.05).

CONCLUSION

The data suggested that PD to match fluid losses during exercise in the heat provided a performance advantage because of lower thermoregulatory strain and greater sweating responses.

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

OBJECTIVE

  To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals.

BACKGROUND

  Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals.

RECOMMENDATIONS

  Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

The Effect of Fluid Intake Following Dehydration on Subsequent Athletic and Cognitive Performance: a Systematic Review and Meta-analysis

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.

Effect of hypohydration on thermoregulatory responses in men with low and high body fat exercising in the heat

It is unclear whether men with low body fat (LO-BF) have impaired thermoregulation during exercise heat stress compared with those with high body fat (HI-BF) when euhydration (EU) is maintained. Furthermore, in LO-BF individuals, hypohydration (HY) impairs thermoregulatory responses during exercise heat stress, but it is unknown whether this occurs in HI-BF counterparts. The purpose of this study was to test the hypotheses that men with HI-BF have impaired thermoregulatory responses to exercise heat stress and that HY further exacerbates these impairments vs. LO-BF. Men with LO-BF [ n = 11, body mass (BM) 73.9 ± 8.5 kg, BF% 13.6 ± 3.8] and HI-BF ( n = 9, BM 89.6 ± 6.9 kg, BF% 30.2 ± 4.1), in a randomized crossover design, performed 60 min of upright cycling in a hot environment (40.3 ± 0.4°C, relative humidity 32.5 ± 1.9%) at a metabolic heat production rate of 6 W/kg BM and finished exercise either euhydrated (EU; 0.3 ± 1.2 vs. 0.3 ± 0.9% BM loss) or HY (−2.5 ± 1.1 vs. −1.7 ± 1.5% BM loss). Changes in rectal temperature (ΔTrec), local sweat rate (ΔLSR), and cutaneous vascular conductance (ΔCVC; %max) were measured throughout. When EU, LO-BF and HI-BF had similar CVC and LSR responses ( P > 0.05); however, LO-BF had a lower ΔTrec vs. HI-BF (0.92 ± 0.35 vs. 1.31 ± 0.32°C, P = 0.021). Compared with EU, HY increased end-exercise ΔTrec in LO-BF (0.47 ± 0.37°C, P < 0.01) but not in HI-BF (−0.06 ± 0.29°C, P > 0.05). HY, compared with EU, did not affect ΔLSR and ΔCVC in either group ( P > 0.05). We conclude that, when euhydrated, men with HI-BF have a greater increase in Trec vs. LO-BF but similar CVC and LSR. HY exacerbates increases in Trec in LO-BF but not HI-BF.

NEW & NOTEWORTHY This is the first known investigation to compare thermoregulatory responses to exercise heat stress between men with high and low body fat (BF) in a physiologically uncompensable environment while simultaneously examining the confounding influence of hydration status. Both groups demonstrated similar sweating and cutaneous vasodilatory responses when euhydrated, despite vast differences in rectal temperature. Furthermore, in contrast to low BF, individuals with high BF demonstrated similar increases in core body temperature when either euhydrated or hypohydrated.

Fluid Balance of Adolescent Swimmers During Training

Swimming, either competitively or leisurely, is a unique activity that involves prolonged exercise while immersed in stable water temperatures. This environment could have an influence on the hydration status of swimmers independently of fluid balance. Forty-six healthy adolescent swimmers (26 males and 20 females; 12.8 ± 2.3 years; 50.6 ± 13.4 kg) were studied during a typical training session in an indoor swimming pool. First morning, prepractice and postpractice urine samples were tested for osmolality and specific gravity, whereas all athletes consumed fluids ad libitum. Sixty-seven percent of the athletes were hypohydrated (urine osmolality [Uosm] ≥700 mmol·kg(-1)) based on their first morning urine sample, which increased to 78% immediately before training. During the 2-hour swimming practice, the minimal sweat loss (0.39 ± 0.27 L) combined with ad libitum fluid availability resulted in unchanged body weight (0.1 ± 0.3 kg). Additionally, thirst was similar (before practice: 46 ± 26, after practice: 55 ± 33 mm on a 100-mm visual analog scale) at pretraining and posttraining time points (p > 0.05). Interestingly, postpractice Uosm was reduced significantly compared with the prepractice value (630 vs. 828 mmol·kg(-1); p = 0.001), without any significant change in body weight (0.1 ± 0.3 kg; p > 0.05). In conclusion, the present data indicated that more than two-thirds of the young swimmers appeared in their practice suboptimally hydrated. Although no changes in body mass were observed during the swimming practice, the decrease in urine hydration markers after swimming might less accurately reflect hydration state.

Fluid Balance During Training in Elite Young Athletes of Different Sports

Although there are many studies demonstrating a high percentage of adult athletes who start exercise in suboptimal hydration state, limited data concerning hydration levels in athletic youth exist. The purpose of this study was to identify the hydration status of elite young athletes of different sports, during a typical day of training. Fifty-nine young elite male athletes from different sports (basketball, gymnastics, swimming, running, and canoeing) participated in the study (age: 15.2 ± 1.3 years; years of training: 7.7 ± 2.0). Hydration status was assessed in the morning, before and immediately after practice. Data collection took place at the same time of the day, with mean environmental temperature and humidity at the time of the measurements at 27.6 ± 0.9° C and 58 ± 8%, respectively. All athletes trained for approximately 90 minutes, and they were consuming fluids ad libitum throughout their practice. Over 89% of the athletes were hypohydrated (urine specific gravity [USG] ≥1.020 mg·dl) based on their first morning urine sample. Pretraining urine samples revealed that 76.3% of the athletes were hypohydrated, whereas a significant high percent remained hypohydrated even after training according to USG values ≥1.020 mg·dl (74.5%) and urine color scale: 5-6 (76.3%). Mean body weight loss during training was -1.1 ± 0.07%. We concluded that the prevalence of hypohydration among elite young athletes is very high, as indicated by the USG and urine color values. The majority of the athletes was hypohydrated throughout the day and dehydrated even more during practice despite fluid availability.

The effect of dehydration on muscle metabolism and time trial performance during prolonged cycling in males

This study combined overnight fluid restriction with lack of fluid intake during prolonged cycling to determine the effects of dehydration on substrate oxidation, skeletal muscle metabolism, heat shock protein 72 (Hsp72) response, and time trial (TT) performance. Nine males cycled at ∼65% VO_2peak for 90 min followed by a TT (6 kJ/kg BM) either with fluid (HYD) or without fluid (DEH). Blood samples were taken every 20 min and muscle biopsies were taken at 0, 45, and 90 min of exercise and after the TT. DEH subjects started the trial with a −0.6% BM from overnight fluid restriction and were dehydrated by 1.4% after 45 min, 2.3% after 90 min of exercise, and 3.1% BM after the TT. There were no significant differences in oxygen uptake, carbon dioxide production, or total sweat loss between the trials. However, physiological parameters (heart rate [HR], rate of perceived exertion, core temperature [Tc], plasma osmolality [Posm], plasma volume [Pvol] loss, and Hsp72), and carbohydrate (CHO) oxidation and muscle glycogen use were greater during 90 min of moderate cycling when subjects progressed from 0.6% to 2.3% dehydration. TT performance was 13% slower when subjects began 2.3% and ended 3.1% dehydrated. Throughout the TT, Tc, Posm, blood and muscle lactate [La], and serum Hsp72 were higher, even while working at a lower power output (PO). The accelerated muscle glycogen use during 90 min of moderate intensity exercise with DEH did not affect subsequent TT performance, rather augmented Tc, RPE and the additional physiological factors were more important in slowing performance when dehydrated.

Physiological and psychological responses to outdoor vs. laboratory cycling

The purpose of this study was to determine the physiological and psychological responses to laboratory vs. outdoor cycling. Twelve recreationally trained male cyclists participated in an initial descriptive testing session and 2 experimental trials consisting of 1 laboratory and 1 outdoor session, in a randomized order. Participants were given a standardized statement instructing them to give the same perceived effort for both the laboratory and outdoor 40-km trials. Variables measured include power output, heart rate (HR), core temperature, skin temperature, body weight, urine specific gravity (USG), Rating of Perceived Exertion (RPE), attentional focus, and environmental conditions. Wind speed was higher in the outdoor trial than in the laboratory trial (2.5 ± 0.6 vs. 0.0 ± 0.0 m·s-1, p = 0.02) whereas all other environmental conditions were similar. Power output (208.1 ± 10.2 vs. 163.4 ± 11.8 W, respectively, p < 0.001) and HR (152 ± 4 and 143 ± 6 b·min-1, respectively, p = 0.04) were higher in the outdoor trial than in the laboratory trial. Core temperature was similar, whereas skin temperature was cooler during the outdoor trial than during the laboratory trial (31.4 ± 0.3 vs. 33.0 ± 0.2° C, respectively, p < 0.001), thus creating a larger thermal gradient between the core and skin outdoors. No significant differences in body weight, USG, RPE, or attentional focus were observed between trials. These data indicate that outdoor cycling allows cyclists to exercise at a higher intensity than in laboratory cycling, despite similar environmental conditions and perceived exertion. In light of this, cyclists may want to ride at a higher perceived exertion in indoor settings to acquire the same benefit as they would from an outdoor ride.

Are we being drowned in hydration advice? Thirsty for more?

Hydration pertains simplistically to body water volume. Functionally, however, hydration is one aspect of fluid regulation that is far more complex, as it involves the homeostatic regulation of total body fluid volume, composition and distribution. Deliberate or pathological alteration of these regulated factors can be disabling or fatal, whereas they are impacted by exercise and by all environmental stressors (e.g. heat, immersion, gravity) both acutely and chronically. For example, dehydration during exercising and environmental heat stress reduces water volume more than electrolyte content, causing hyperosmotic hypohydration. If exercise continues for many hours with access to food and water, composition returns to normal but extracellular volume increases well above baseline (if exercising upright and at low altitude). Repeating bouts of exercise or heat stress does likewise. Dehydration due to physical activity or environmental heat is a routine fluid-regulatory stress. How to gauge such dehydration and - more importantly-what to do about it, are contested heavily within sports medicine and nutrition. Drinking to limit changes in body mass is commonly advocated (to maintain ≤2% reduction), rather than relying on behavioural cues (mainly thirst) because the latter has been deemed too insensitive. This review, as part of the series on moving in extreme environments, critiques the validity, problems and merits of externally versus autonomously controlled fluid-regulatory behaviours, both acutely and chronically. Our contention is that externally advocated hydration policies (especially based on change in body mass with exercise in healthy individuals) have limited merit and are extrapolated and imposed too widely upon society, at the expense of autonomy. More research is warranted to examine whether ad libitum versus avid drinking is beneficial, detrimental or neither in: acute settings; adapting for obligatory dehydration (e.g. elite endurance competition in the heat), and; development of chronic diseases that are associated with an extreme lack of environmental stress.