Search

Purpose: Rapid gastric emptying and intestinal absorption of beverages is essential for rapid rehydration, and certain amino acids (AA) may augment fluid delivery. Three sugar-free beverages, containing differing AA concentrations (AA + PZ), were assessed for fluid absorption kinetics against commercial sugar-free (PZ, GZ) and carbohydrate-containing (GTQ) beverages., Methods: Healthy individuals (n = 15-17 per study) completed three randomised trials. Three beverages (550-600 mL) were ingested in each study (Study 1: AA + PZ [17.51 g/L AA], PZ, GZ; Study 2: AA + PZ [6.96 g/L AA], PZ, GZ; Study 3: AA + PZ [3.48 g/L AA], PZ, GTQ), containing 3.000 g deuterium oxide (D 2 O). Blood samples were collected pre-, 2-min, 5-min, and every 5-min until 60-min post-ingestion to quantify maximal D 2 O enrichment (Cmax), time Cmax occurred (Tmax) and area under the curve (AUC)., Results: Study 1: AUC (AA + PZ: 15,184 ± 3532 δ‰ vs. VSMOW; PZ: 17,328 ± 3153 δ‰ vs. VSMOW; GZ: 17,749 ± 4204 δ‰ vs. VSMOW; P ≤ 0.006) and Tmax (P ≤ 0.005) were lower for AA + PZ vs. PZ/GZ. Study 2: D 2 O enrichment characteristics were not different amongst beverages (P ≥ 0.338). Study 3: Cmax (AA + PZ: 440 ± 94 δ‰ vs. VSMOW; PZ: 429 ± 83 δ‰ vs. VSMOW; GTQ: 398 ± 81 δ‰ vs. VSMOW) was greater (P = 0.046) for AA + PZ than GTQ, with no other differences (P ≥ 0.106)., Conclusion: The addition of small amounts of AA (3.48 g/L) to a sugar-free beverage increased fluid delivery to the circulation compared to a carbohydrate-based beverage, but greater amounts (17.51 g/L) delayed delivery., (© 2024. The Author(s).)

It is well appreciated that a loss of body water (dehydration) can impair endurance performance and that the effect is magnified by environmental heat stress. A majority of professional sports medicine and nutrition organizations recommend drinking during exercise to replace sweat losses and prevent dehydration, while also avoiding frank over-hydration. Knowledge of sweating rate, which is highest in the heat for any given metabolic rate, is therefore considered key to developing a sound drinking strategy. Exercise duration and the provision of liquid fuel interacts with required drink volumes in important ways that are infrequently discussed but are of utmost practical concern. This review details some challenges related to the optimized coupling of fluid and fuel needs during prolonged exercise in the heat and the need for personalization., (Copyright © 2021. Published by Elsevier Ltd.)

Background: The efficacy of different commercial beverage compositions for meeting oral rehydration therapy (ORT) goals in the treatment of acute dehydration in healthy humans has not been systematically tested. The objective of the study was to compare fluid retention, plasma volume (PV), and interstitial fluid (ISF) volume restoration when using 1 popular glucose-based and 1 novel amino acid-based (AA) commercial ORT beverage following experimental hypertonic or isotonic dehydration., Methods: Twenty-six healthy adults (21 males, 5 females) underwent either a controlled bout of hypertonic (n = 13) or isotonic (n = 13) dehydration (3%-4% body mass) via eccrine or renal body water and electrolyte losses induced using exercise-heat stress (EHS) or Lasix administration (LAS), respectively. Rehydration was achieved over 90 minutes by matching fluid intake to water losses (1:1) using a sports drink (SP) or AA commercial ORT beverage. Fluid retention (water and electrolytes), PV, and ISF volume changes were tracked for 180 minutes., Results: AA produced significantly (P <0.05) greater fluid retention (75% vs 57%), ISF volume restoration, and tended (P = 0.06) to produce greater PV restoration in trial EHS. In trial LAS, neither beverage exceeded 65% retention, but AA replaced electrolytes and preserved ISF volume better than SP (P <0.05)., Conclusion: The results of this study demonstrate superior rehydration when using AA compared with SP for both hypertonic and isotonic dehydration., (© 2018 American Society for Parenteral and Enteral Nutrition.)

Background: Fluid intake during military training is prescribed based on the interactions among work rates, environmental conditions, and uniform configurations. The efficacy of this guidance has not been empirically assessed in over a decade. To determine the acceptability of the fluid intake guidance, sweat losses were measured in a variety of conditions with modern uniform/body armor configurations and were then compared to prescribed fluid intakes for each condition (workload, environment, clothing)., Methods: Whole body sweat losses of 324 Soldiers and 14 model simulations were measured under a variety of work intensities ((Watts) easy, moderate, hard), work durations (2-25 h), environmental conditions (White-Black flag), and uniform configurations (including Army Combat Uniform and body armor). Whole body sweat losses were then calculated relative to 4 h drinking guidance and in accordance with TB MED 507 recommended work/rest ratios. The differences between the prescribed fluid intake and sweat loss were calculated and expressed as a percent loss or gain of body weight. Values within a threshold of ±2% body water flux (BWF) were deemed an acceptable conservative starting point for performance and health concerns., Findings: Values within ±2% BWF numbered 309/338; 25 of 338 observations exceeded the +2% BWF while 4 of 338 observations exceeded the -2% BWF. When total fluid restriction was simulated, all experienced body weight loss with 151 of 338 observations exceeding the -2% BWF., Discussion: When calculated using actual measured sweating rates from the laboratory and model simulations, current fluid intake guidance appears to predict with 91.4% accuracy the volume of fluid required to maintain a proper euhydrated state (±2%) during 4 h of exercise. Simulations of total fluid restriction support the necessity for fluid intake guidance so that the Warfighter's performance does not degrade. It is recommended that the current military fluid intake guidance focuses on methods for accurately tracking fluid intakes., (Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2018.)

Background: The water-deficit equation {WD(1) = 0.6 × B(m) × [1 - (140 ÷ Na(+))]; B(m) denotes body mass} is used in medicine and nutrition to estimate the volume (L) of water required to correct dehydration during the initial stages of fluid-replacement therapy. Several equation assumptions may limit its accuracy, but none have been systematically tested., Objectives: We quantified the potential error in WD(1) for the estimation of free water (FW) and total body water (TBW) losses and systematically evaluated its assumptions., Design: Thirty-six euhydrated volunteers were dehydrated (2.2-5.8% B(m)) via thermoregulatory sweating. Assumptions within WD(1) were tested by substituting measured euhydrated values for assumed or unknown values. These included the known (premorbid) B(m) (WD(2)), a proposed correction for unknown B(m) (WD(3)), the TBW estimated from body composition (WD(4)), the actual plasma sodium (WD(5)), the substitution of plasma osmolality (Posm) for sodium (WD(6)), and actual Posm (WD(7))., Results: Dehydration reduced TBW by 3.49 ± 0.91 L, 57% of which (2.02 ± 0.96 L) was FW loss, and increased plasma sodium from 139 (range: 135-143 mmol/L) to 143 (range: 141-148 mmol/L) mmol/L. Calculations for WD(1) through WD(7) all underestimated TBW loss by 1.5-2.5 L (P < 0.05). WD(1) through WD(5) underestimated FW by 0.5 L to 1.0 L (P < 0.05), but WD(6) and WD(7) estimated FW loss to within 0.06-0.16 L (P > 0.05)., Conclusions: WD(1) grossly underestimates TBW and FW losses. Corrections for unknowns and assumptions (WD(2) through WD(5)) improved estimates little. The use of WD(6) = 0.6 × B(m) × [1 - (290 ÷ Posm)] accurately estimates FW but still underestimates TBW losses by >40%.

When performing physical work, sweat output often exceeds water intake, producing a body water deficit or dehydration. Specific to the work place, dehydration can adversely affect worker productivity, safety, and morale. Legislative bodies in North America such as the Occupational Safety and Health Administration (OSHA) and the American Conference of Governmental Industrial Hygienists (ACGIH) recommend replacing fluids frequently when exposed to heat stress, such as one cup (250 ml) every 20 minutes when working in warm environments. However, the majority of legislative guidelines provide vague guidance and none take into account the effects of work intensity, specific environments, or protective clothing. Improved occupational guidelines for fluid and electrolyte replacement during hot weather occupational activities should be developed to include recommendations for fluid consumption before, during, and after work.

This study examined the effects of rehydration (Rehy) with fluids of varying tonicities and routes of administration after exercise-induced hypohydration on exercise performance, fluid regulatory hormone responses, and cardiovascular and thermoregulatory strain during subsequent exercise in the heat. On four occasions, eight men performed an exercise-dehydration protocol of approximately 185 min (33 degrees C) to establish a 4% reduction in body weight. Following dehydration, 2% of the fluid lost was replaced during the first 45 min of a 100-min rest period by one of three random Rehy treatments (0.9% saline intravenous; 0.45% saline intravenous; 0.45% saline oral) or no Rehy (no fluid) treatment. Subjects then stood for 20 min at 36 degrees C and then walked at 50% maximal oxygen consumption for 90 min. Subsequent to dehydration, plasma Na(+), osmolality, aldosterone, and arginine vasopressin concentrations were elevated (P < 0.05) in each trial, accompanied by a -4% hemoconcentration. Following Rehy, there were no differences (P > 0.05) in fluid volume restored, post-rehydration (Post-Rehy) body weight, or urine volume. Percent change in plasma volume was 5% above pre-Rehy values, and plasma Na(+), osmolality, and fluid regulatory hormones were lower compared with no fluid. During exercise, skin and core temperatures, heart rate, and exercise time were not different (P > 0.05) among the Rehy treatments. Plasma osmolality, Na(+), percent change in plasma volume, and fluid regulatory hormones responded similarly among all Rehy treatments. Neither a fluid of greater tonicity nor the route of administration resulted in a more rapid or greater fluid retention, nor did it enhance heat tolerance or diminish physiological strain during subsequent exercise in the heat.

Purpose: This study sought to determine the effect of rapid intravenous (IV) versus oral (ORAL) rehydration immediately after dehydration, on cardiovascular, thermoregulatory, and perceptual responses during subsequent exercise in the heat., Methods: Eight males (21.4 +/- 0.7 yr; 176.2 +/- 1.6 cm; 75.2 +/- 3.7 kg; 63.7 +/- 3.6 mL.kg.min VO2max, 9.0 +/- 1.7% fat) participated in three randomized trials. Each trial consisted of a 75-min dehydration phase (36 degrees C; 42.5% rh, 47 +/- 0.9% VO2max) where subjects lost 1.7 L (IV and no-fluid (NF) trials) to 1.8 L of fluid (ORAL trial). In the heat, fluid lost was matched with 0.45% saline in 20 min by either IV or ORAL rehydration; no fluid was given in the NF trial. Subjects then performed a heat-tolerance test (HTT; 37.0 degrees C, 45% rh, treadmill speed of 2.4 m.s, 2.3% grade) for 75 min or until exhaustion (Tre of 39.5 degrees C). During the HTT, thermal and thirst sensations, RPE, rectal temperature (Tre), heart rate (HR), and mean weighted skin temperature (Tsk) were measured., Results: Plasma volume in the IV treatment was greater (P < 0.05) after rehydration compared with ORAL and NF. However, during the HTT there were no overall differences (P > 0.05) in HR, Tre, Tsk, RPE, thermal sensations, or HTT time (ORAL, 71 +/- 8 min; IV, 73 +/- 5 min; NF, 39 +/- 29 min) between the ORAL and IV treatments. Sensations of thirst were lower (P < 0.05) in ORAL compared with IV and NF, likely because of oropharyngeal stimuli., Conclusions: Despite a more rapid restoration of plasma volume, IV rehydration was not advantageous over ORAL rehydration in regards to physiological strain, heat tolerance, RPE, or thermal sensations.

This investigation examined plasma arginine vasopressin (AVP) and aldosterone (Ald) responses to 1) oral and intravenous (IV) methods of rehydration (Rh) and 2) different IV Rh osmotic loads. We hypothesized that AVP and Ald responses would be similar between IV and oral Rh and that the greater osmolality and sodium concentration of a 0.9% IV saline treatment would stimulate a greater AVP response compared with a 0.45% IV saline treatment. On four occasions, eight men (age: 22.1 +/- 0.8 yr; height: 179.6 +/- 1.5 cm; weight: 73.6 +/- 2.5 kg; maximum O(2) consumption: 57.9 +/- 1.6 ml. kg(-1). min(-1), body fat: 7.7 +/- 0.9%) performed a dehydration (Dh) protocol (33 degrees C) to establish a 4-5% reduction in body weight. After Dh, subjects underwent each of three randomly assigned Rh (back to -2% body wt) treatments (0.9 and 0.45% IV saline, 0.45% oral saline) and a no Rh treatment during the first 45 min of a 100-min rest period. Blood samples were obtained pre-Dh, immediately post-Dh, and at 15, 35, and 55 min post-Rh. Before Dh, plasma AVP and Ald were not different among treatments but were significantly elevated post-Dh. In general, at 15, 35, and 55 min post-Rh, AVP, Ald, osmolality, and plasma volume shifts did not differ between IV and oral fluid replacement. These results demonstrated that the manner in which plasma AVP and Ald responded to oral and IV Rh or to different sodium concentrations (0.9 vs. 0.45%) was not different given the degree of Dh (-4.5% body wt) and Rh and amount of time after Rh (55 min).

This study compared the influence of intravenous vs. oral rehydration after exercise-induced dehydration during a subsequent 90-min exercise bout. It was hypothesized that cardiovascular, thermoregulatory, and hormonal variables would be the same between intravenous and oral rehydration because of similar restoration of plasma volume (PV) and osmolality (Osmo). Eight non-heat-acclimated men received three experimental treatments (counterbalanced design) immediately after exercise-induced dehydration (33 degrees C) to -4% body weight loss. Treatments were intravenous 0.45% NaCl (iv; 25 ml/kg), no fluid (NF), and oral saline (Oral; 25 ml/kg). After rehydration and rest (2 h total), subjects walked at 50% maximal O2 consumption for up to 90 min at 36 degrees C. The following observations were made: 1) heart rate was higher (P < 0.05) in Oral vs. iv at minutes 45, 60, and 75 of exercise; 2) rectal temperature, sweat rate, percent change in PV, and change in plasma Osmo were similar between iv and Oral; 3) change in plasma norepinephrine decreased less (P < 0.05) in Oral compared with iv at minute 45; 4) changes in plasma adrenocorticotropic hormone and cortisol were similar between iv and Oral after exercise was initiated; and 5) exercise time was similar between iv (77.4 +/- 5.4 min) and Oral (84.2 +/- 2.3 min). These data suggest that after exercise-induced dehydration, iv and Oral were equally effective as rehydration treatments. Thermoregulation, change in adrenocorticotropic hormone, and change in cortisol were not different between iv and Oral after exercise began; this is likely due to similar percent change in PV and change in Osmo.

The purpose of this investigation was to compare the effects of oral and intravenous saline rehydration on differentiated ratings of perceived exertion (RPE) and thirst. Eight men underwent three randomly assigned rehydration treatments following a 2- to 4-h exercise-induced dehydration bout to reduce body weight by 4%. Treatments included 0.45% saline infusion (i.v.), 0.45% saline oral ingestion (ORAL), and no fluid (NF). Following rehydration and rest (2 h total), subjects walked at 50% VO2max for 90 min at 36 degrees C (EX). Central RPE during ORAL was lower (P < 0.05) than i.v. and NF throughout EX. Local RPE during NF was higher (P < 0.05) than i.v. and ORAL at minutes 20 and 40 of EX and overall RPE during NF was higher (P < 0.05) than ORAL at minutes 20 and 40 of EX. Significant correlations were found between overall RPE and mean skin temperature for i.v. (r = 0.72) and NF (r = 0.75), and between overall RPE and thirst ratings for i.v. (r = 0.70). Thirst ratings were not different among trials at postdehydration. Following rehydration, thirst was higher (P < 0.05) during NF than i.v. and ORAL and lower (P < 0.05) during ORAL than i.v. at all subsequent time points. Results suggest that oral rehydration is likely to elicit lower RPE and thirst ratings compared with intravenous rehydration.