Evaluation of Pragmatic Methods to Rapidly Assess Habitual Beverage Intake and Hydration Status in U.S. Collegiate Athletes

in International Journal of Sport Nutrition and Exercise Metabolism
Restricted access

Purchase article

USD  $24.95

Student 1 year online subscription

USD  $88.00

1 year online subscription

USD  $118.00

Student 2 year online subscription

USD  $168.00

2 year online subscription

USD  $224.00

Fluid intake recommendations have been established for the athletic population in order to promote adequate hydration. The Beverage Intake Questionnaire (BEVQ-15) is a quick and reliable food frequency questionnaire that quantifies habitual beverage intake, which has been validated in children, adolescents, and adults. However, no validated beverage consumption questionnaire is available for collegiate athletes. Urine color (UC), while feasible for determining hydration status, has not been validated within a variety of collegiate athletes. The purpose of this investigation was to evaluate the comparative validity and reliability of pragmatic methods to rapidly assess BEVQ-15 and UC rating in U.S. Division I collegiate athletes. Student-athletes (n = 120; 54% females; age 19 ± 1 years) from two universities were recruited to complete three study sessions. At the first and third sessions, the participants completed the BEVQ-15 and provided a urine sample to determine UC and urinary specific gravity. All sessions included completion of a 24-hr dietary recall. Total fluid intake (fl oz) was 111 ± 107 and 108 ± 42 using the BEVQ-15 and the mean of three 24-hr dietary recalls, respectively, which was not different between methods (p > .05). There were moderate associations between the BEVQ-15 and dietary recall results for total beverage intake fl oz and kcal(r = .413 and r = 4.65; p ≤ .05, respectively). Strong associations were noted between both researcher-rated and participant-rated UC with urinary specific gravity measures (r = .675 and r = .884; p ≤ .05, respectively). Therefore, these rapid assessment methods demonstrated acceptable validity and may be used as practical methods to determine whether athletes are meeting their hydration recommendations.

Kostelnik, Rockwell, K. Davy, Hedrick, and B. Davy are with the Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA. Thomas is with the Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA.

Kostelnik (samak94@vt.edu) is corresponding author.
  • Armstrong, L.E. (2007). Assessing hydration status: The elusive gold standard. Journal of the American College of Nutrition, 26(suppl 5), 575S584S. doi:10.1080/07315724.2007.10719661

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Armstrong, L.E., Johnson, E.C., Munoz, C.X., Swokla, B., Le Bellego, L., Jimenez, L., … Maresh, C.M. (2012). Hydration biomarkers and dietary fluid consumption of women. Journal of the Academy of Nutrition and Dietetics, 112(7), 10561061. PubMed ID: 22889635 doi:10.1016/j.jand.2012.03.036

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Armstrong, L.E., Maresh, C.M., Castellani, J.W., Bergeron, M.F., Kenefick, R.W., LaGasse, K.E., & Riebe, D. (1994). Urinary indices of hydration status. International Journal of Sport Nutrition, 4(3), 265279. PubMed ID: 7987361 doi:10.1123/ijsn.4.3.265

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Armstrong, L.E., Pumerantz, A.C., Fiala, K.A., Roti, M.W., Kavouras, S.A., Casa, D.J., & Maresh, C.M. (2010). Human hydration indices: Acute and longitudinal reference values. International Journal of Sport Nutrition and Exercise Metabolism, 20(2), 145153. PubMed ID: 20479488 doi:10.1123/ijsnem.20.2.145

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Arnaoutis, G., Kavouras, S.A., Angelopoulou, A., Skoulariki, C., Bismpikou, S., Mourtakos, S., & Sidossis, L.S. (2015). Fluid balance during training in elite young athletes of different sports. The Journal of Strength and Conditioning Research, 29(12), 34473452. PubMed ID: 24513625 doi:10.1519/JSC.0000000000000400

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Binkley, H.M., Beckett, J., Casa, D.J., Kleiner, D.M., & Plummer, P.E. (2002). National athletic trainers’ association position statement: Exertional heat illnesses. Journal of Athletic Training, 37(3), 329343. PubMed ID: 12937591

    • Search Google Scholar
    • Export Citation
  • Bottin, J.H., Lemetais, G., Poupin, M., Jimenez, L., & Perrier, E.T. (2016). Equivalence of afternoon spot and 24-h urinary hydration biomarkers in free-living healthy adults. European Journal of Clinical Nutrition, 70(8), 904907. PubMed ID: 26757833 doi:10.1038/ejcn.2015.217

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Casa, D.J., Armstrong, L.E., Hillman, S.K., Montain, S.J., Reiff, R.V., Rich, B.S., … Stone, J.A. (2000). National athletic trainers’ association position statement: Fluid replacement for athletes. Journal of Athletic Training, 35(2), 212224. PubMed ID: 16558633

    • Search Google Scholar
    • Export Citation
  • Castro-Sepulveda, M., Cerda-Kohler, H., Perez-Luco, C., Monsalves, M., Andrade, D.C., Zbinden-Foncea, H., … Ramirez-Campillo, R. (2014). Hydration status after exercise affect resting metabolic rate and heart rate variability. Nutricion Hospitalaria, 31(3), 12731277. PubMed ID: 25726222 doi:10.3305/nh.2015.31.3.8523

    • Search Google Scholar
    • Export Citation
  • Clarke, M.M., Stanhewicz, A.E., Wolf, S.T., Cheuvront, S.N., Kenefick, R.W., & Kenney, W.L. (2019). A randomized trial to assess beverage hydration index in healthy older adults. The American Journal of Clinical Nutrition, 109(6), 16401647. PubMed ID: 31051498 doi:10.1093/ajcn/nqz009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dogan, N.O. (2018). Bland-Altman analysis: A paradigm to understand correlation and agreement. Turkish Journal of Emergency Medicine, 18(4), 139141. PubMed ID: 30533555 doi:10.1016/j.tjem.2018.09.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ellis, L.A., Yates, B.A., McKenzie, A.L., Muñoz, C.X., Casa, D.J., & Armstrong, L.E. (2016). Effects of three oral nutritional supplements on human hydration indices. International Journal of Sport Nutrition and Exercise Metabolism, 26(4), 356362. PubMed ID: 26731792 doi:10.1123/ijsnem.2015-0244

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fausnacht, A.G., Myers, E.A., Hess, E.L., Davy, B.M., & Hedrick, V.E. (2020). Update of the BEVQ-15, a beverage intake questionnaire for habitual beverage intake for adults: Determining comparative validity and reproducibility. Journal of Human Nutrition and Dietetics, 33(5), 729737. PubMed ID: 32283572 doi:10.1111/jhn.12749

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hahn, R.G., & Waldreus, N. (2013). An aggregate urine analysis tool to detect acute dehydration. International Journal of Sport Nutrition and Exercise Metabolism, 23(4), 303311. PubMed ID: 23994895 doi:10.1123/ijsnem.23.4.303

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hancock, P.A., & Vasmatzidis, I. (2003). Effects of heat stress on cognitive performance: The current state of knowledge. International Journal of Hyperthermia, 19(3), 355372. PubMed ID: 12745975 doi:10.1080/0265673021000054630

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hedrick, V.E., Comber, D.L., Estabrooks, P.A., Savla, J., & Davy, B.M. (2010). The beverage intake questionnaire: Determining initial validity and reliability. Journal of the American Dietetic Association, 110(8), 12271232. PubMed ID: 20656099 doi:10.1016/j.jada.2010.05.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hedrick, V.E., Comber, D.L., Ferguson, K.E., Estabrooks, P.A., Savla, J., Dietrich, A.M., … Davy, B.M. (2013). A rapid beverage intake questionnaire can detect changes in beverage intake. Eating Behaviors, 14(1), 9094. PubMed ID: 23265410 doi:10.1016/j.eatbeh.2012.10.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hedrick, V.E., Savla, J., Comber, D.L., Flack, K.D., Estabrooks, P.A., Nsiah-Kumi, P.A., … Davy, B.M. (2012). Development of a brief questionnaire to assess habitual beverage intake (BEVQ-15): Sugar-sweetened beverages and total beverage energy intake. Journal of the Academy of Nutrition and Dietetics, 112(6), 840849. PubMed ID: 22709811 doi:10.1016/j.jand.2012.01.023

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hill, C.E., MacDougall, C.R., Riebl, S.K., Savla, J., Hedrick, V.E., & Davy, B.M. (2017). Evaluation of the relative validity and test-retest reliability of a 15-Item beverage intake questionnaire in children and adolescents. Journal of the Academy of Nutrition and Dietetics, 117(11), 17571766.e5. PubMed ID: 28673606 doi:10.1016/j.jand.2017.05.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hooper, L.P., Myers, E.A., Zoellner, J.M., Davy, B.M., & Hedrick, V.E. (2017). The impact of health literacy status on the comparative validity and sensitivity of an interactive multimedia beverage intake questionnaire. Nutrients, 9(1), 5. doi:10.3390/nu9010005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Karras, D.J. (1997). Statistical methodology: II. Reliability and validity assessment in study design, Part B. Academic Emergency Medicine, 4(2), 144147. PubMed ID: 9043544 doi:10.1111/j.1553-2712.1997.tb03723.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kirkpatrick, S.I., Baranowski, T., Subar, A.F., Tooze, J.A., & Frongillo, E.A. (2019). Best practices for conducting and interpreting studies to validate self-report dietary assessment methods. Journal of the Academy of Nutrition and Dietetics, 119(11), 18011816. PubMed ID: 31521583 doi:10.1016/j.jand.2019.06.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kostelnik, S.B., Davy, K.P., Hedrick, V.E., Thomas, D.T., & Davy, B.M. (2020). The validity of urine color as a hydration biomarker within the general adult population and athletes: A systematic review. Journal of the American College of Nutrition . Advance online publication. doi:10.1080/07315724.2020.1750073

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Lora, K.R., Davy, B., Hedrick, V., et al. (2016). Assessing initial validity and reliability of a beverage intake questionnaire in hispanic preschool-aged children. Journal of the Academy of Nutrition and Dietetics, 116(12), 19511960. PubMed ID: 27554270 doi:10.1016/j.jand.2016.06.376

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maughan, R.J., & Shirreffs, S.M. (2004). Rehydration and recovery after exercise. Science & Sports, 19(5), 234238. doi:10.1016/j.scispo.2004.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maughan, R.J., Watson, P., Cordery, P.A., Walsh, N.P., Oliver, S.J., Dolci, A., … Galloway, S.D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: Development of a beverage hydration index. The American Journal of Clinical Nutrition, 103(3), 717723. PubMed ID: 26702122 doi:10.3945/ajcn.115.114769

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McHugh, M.L. (2012). Interrater reliability: The kappa statistic. Biochemia Medica (Zagreb), 22(3), 276282. doi:10.11613/BM.2012.031

  • Moshfegh, A.J., Rhodes, D.G., Baer, D.J., Murayi, T., Clemens, J.C., Rumpler, W.V., … Cleveland, L.E. (2008). The US Department of Agriculture automated multiple-pass method reduces bias in the collection of energy intakes. The American Journal of Clinical Nutrition, 88(2), 324332. PubMed ID: 18689367 doi:10.1093/ajcn/88.2.324

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mukaka, M.M. (2012). Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Medical Journal, 24(3), 6971. PubMed ID: 23638278

    • Search Google Scholar
    • Export Citation
  • Nuccio, R.P., Barnes, K.A., Carter, J.M., & Baker, L.B. (2017). Fluid balance in team sport athletes and the effect of hypohydration on cognitive, technical, and physical performance. Sports Medicine, 47(10), 19511982. PubMed ID: 28508338 doi:10.1007/s40279-017-0738-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ortega, R.M., Perez-Rodrigo, C., & Lopez-Sobaler, A.M. (2015). Dietary assessment methods: Dietary records. Nutricion Hospitalaria, 31(suppl 3), 3845. PubMed ID: 25719769 doi:10.3305/nh.2015.31.sup3.8749

    • Search Google Scholar
    • Export Citation
  • Perrier, E., Demazières, A., Girard, N., Pross, N., Osbild, D., Metzger, D., … Klein, A. (2013). Circadian variation and responsiveness of hydration biomarkers to changes in daily water intake. European Journal of Applied Physiology, 113(8), 21432151. PubMed ID: 23604869 doi:10.1007/s00421-013-2649-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Riebl, S.K., Paone, A.C., Hedrick, V.E., Zoellner, J.M., Estabrooks, P.A., & Davy, B.M. (2013). The comparative validity of interactive multimedia questionnaires to paper-administered questionnaires for beverage intake and physical activity: Pilot study. JMIR Research Protocols, 2(2), e40. PubMed ID: 24148226 doi:10.2196/resprot.2830

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sawka, M.N., Burke, L.M., Eichner, E.R., Maughan, R.J., Montain, S.J., & Stachenfeld, N.S. (2007). American College of Sports Medicine position stand. Exercise and fluid replacement. Medicine & Science in Sports & Exercise, 39(2), 377390. PubMed ID: 17277604 doi:10.1249/mss.0b013e31802ca597

    • Search Google Scholar
    • Export Citation
  • Stover, E.A., Zachwieja, J., Stofan, J., Murray, R., & Horswill, C.A. (2006). Consistently high urine specific gravity in adolescent American football players and the impact of an acute drinking strategy. International Journal of Sports Medicine, 27(4), 330335. PubMed ID: 16572377 doi:10.1055/s-2005-865667

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thomas, D.T., Erdman, K.A., & Burke, L.M. (2016). Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. Journal of the Academy of Nutrition and Dietetics, 116(3), 501528. PubMed ID: 26920240 doi:10.1016/j.jand.2015.12.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Van Horn, L. (Ed.). (2019). Research: Successful approaches in nutrition and dietetics (4th ed.). Chicago, IL: Academy of Nutrition and Dietetics.

    • Search Google Scholar
    • Export Citation
  • Volpe, S.L., Poule, K.A., & Bland, E.G. (2009). Estimation of prepractice hydration status of National Collegiate Athletic Association Division I athletes. Journal of Athletic Training, 44(6), 624629. PubMed ID: 19911089 doi:10.4085/1062-6050-44.6.624

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 5 5 5
Full Text Views 2 2 2
PDF Downloads 1 1 1