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Effect of Drink Carbohydrate Content on Postexercise Gastric Emptying, Rehydration, and the Calculation of Net Fluid Balance

David J. Clayton, Gethin H. Evans, and Lewis J. James

The purpose of this study was to examine the gastric emptying and rehydration effects of hypotonic and hypertonic glucose-electrolyte drinks after exercise-induced dehydration. Eight healthy males lost ~1.8% body mass by intermittent cycling and rehydrated (150% of body mass loss) with a hypotonic 2% (2% trial) or a hypertonic 10% (10% trial) glucose-electrolyte drink over 60 min. Blood and urine samples were taken at preexercise, postexercise, and 60, 120, 180, and 240 min postexercise. Gastric and test drink volume were determined 15, 30, 45, 60, 90, and 120 min postexercise. At the end of the gastric sampling period 0.3% (2% trial) and 42.1% (10% trial; p < .001) of the drinks remained in the stomach. Plasma volume was lower (p < .01) and serum osmolality was greater (p < .001) at 60 and 120 min during the 10% trial. At 240 min, 52% (2% trial) and 64% (10% trial; p < .001) of the drinks were retained. Net fluid balance was greater from 120 min during the 10% trial (p < .001). When net fluid balance was corrected for the volume of fluid in the stomach, it was greater at 60 and 120 min during the 2% trial (p < .001). These results suggest that the reduced urine output following ingestion of a hypertonic rehydration drink might be mediated by a slower rate of gastric emptying, but the slow gastric emptying of such solutions makes rehydration efficiency difficult to determine in the hours immediately after drinking, compromising the calculation of net fluid balance.

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Assessment of Physical Demands and Fluid Balance in Elite Female Handball Players During a 6-Day Competitive Tournament

Brian Cunniffe, Carissa Fallan, Adora Yau, Gethin H. Evans, and Marco Cardinale

Little data exists on drinking behavior, sweat loss, and exercise intensity across a competitive handball tournament in elite female athletes. Heart rate (HR), fluid balance and sweat electrolyte content were assessed on 17 international players across a 6-day tournament involving 5 games and 2 training sessions played indoors (23 ± 2 °C, 30 ± 2% relative humidity). Active play (effective) mean HR was 155 ± 14 bpm (80 ± 7.5% HRmax) with the majority of time (64%) spent exercising at intensities >80% HRmax. Mean (SD) sweat rates during games were 1.02 ± 0.07 L · h-1 and on 56% of occasions fluid intake matched or exceeded sweat loss. A significant relationship was observed between estimated sweat loss and fluid intake during exercise (r 2 = .121, p = .001). Mean sweat sodium concentration was 38 ± 10 mmol · L-1, with significant associations observed between player sweat rates and time spent exercising at intensities >90% HRmax (r 2 = .181, p = .001). Fluid and electrolyte loss appear to be work rate dependent in elite female handball players, whom appear well capable of replacing fluids lost within a tournament environment. Due to large between-athlete variations, a targeted approach may be warranted for certain players only.

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A Sodium Drink Enhances Fluid Retention During 3 Hours of Post-Exercise Recovery When Ingested With a Standard Meal

Gethin H. Evans, Jennifer Miller, Sophie Whiteley, and Lewis J. James

The purpose of this study was to examine the efficacy of water and a 50 mmol/L NaCl solution on postexercise rehydration when a standard meal was consumed during rehydration. Eight healthy participants took part in two experimental trials during which they lost 1.5 ± 0.4% of initial body mass via intermittent exercise in the heat. Participants then rehydrated over a 60-min period with water or a 50 mmol/L NaCl solution in a volume equivalent to 150% of their body mass loss during exercise. In addition, a standard meal was ingested during this time which was equivalent to 30% of participants predicted daily energy expenditure. Urine samples were collected before and after exercise and for 3 hr after rehydration. Cumulative urine volume (981 ± 458 ml and 577 ± 345 mL; p = .035) was greater, while percentage fluid retained (50 ± 20% and 70 ± 21%; p = .017) was lower during the water compared with the NaCl trial respectively. A high degree of variability in results was observed with one participant producing 28% more urine and others ranging from 18–83% reduction in urine output during the NaCl trial. The results of this study suggest that after exercise induced dehydration, the ingestion of a 50 mmol/L NaCl solution leads to greater fluid retention compared with water, even when a meal is consumed postexercise. Furthermore, ingestion of plain water may be effective for maintenance of fluid balance when food is consumed in the rehydration period.

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Water Balance and Salt Losses in Competitive Football

Ronald J. Maughan, Phillip Watson, Gethin H. Evans, Nicholas Broad, and Susan M. Shirreffs

Fluid balance and sweat electrolyte losses were measured in the players and substitutes engaged in an English Premier League Reserve competitive football match played at an ambient temperature of 6–8 °C (relative humidity 50–60%). Intake of water and/or sports drink and urine output were recorded, and sweat composition was estimated from absorbent swabs applied to 4 skin sites for the duration of the game. Body mass was recorded before and after the game. Data were obtained for 22 players (age 21 y, height 180 cm, mass 78 kg) and 9 substitutes (17 y, 181 cm, 72 kg). All were male. Two of the players were dismissed during the game, and none of the substitutes played any part in the game. Mean ± SD sweat loss of players amounted to 1.68 ± 0.40 L, and mean fluid intake was 0.84 ± 0.47 L (n = 20), with no difference between teams. Corresponding values for substitutes, none of whom played in the match, were 0.40 ± 0.24 L and 0.78 ± 0.46 L (n = 9). Prematch urine osmolality was 678 ± 344 mOsm/kg: 11 of the 31 players provided samples with an osmolality of more than 900 mOsm/kg. Sweat sodium concentration was 62 ± 13 mmol/L, and total sweat sodium loss during the game was 2.4 ± 0.8 g. These descriptive data show a large individual variability in hydration status, sweat losses, and drinking behaviors in a competitive football match played in a cool environment, highlighting the need for individualized assessment of hydration status to optimize fluid-replacement strategies.

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Effect of Exercise Intensity on Subsequent Gastric Emptying Rate in Humans

Gethin H. Evans, Phillip Watson, Susan M. Shirreffs, and Ronald J. Maughan

Previous investigations have suggested that exercise at intensities greater than 70% maximal oxygen uptake (VO2max) reduces gastric emptying rate during exercise, but little is known about the effect of exercise intensity on gastric emptying in the postexercise period. To examine this, 8 healthy participants completed 3 experimental trials that included 30 min of rest (R), low-intensity (L; 33% of peak power output) exercise, or high-intensity (H; 10 × 1 min at peak power output followed by 2 min rest) exercise. Thirty minutes after completion of exercise, participants ingested 595 ml of a 5% glucose solution, and gastric emptying rate was assessed via the double-sampling gastric aspiration method for 60 min. No differences (p > .05) were observed in emptying characteristics for total stomach volume or test meal volume between the trials, and the quantity of glucose delivered to the intestine did not differ between trials (p > .05). Half-emptying times did not differ (p = .902) between trials and amounted to 22 ± 9, 22 ± 9, and 22 ± 7 min (M ± SD) during the R, L, and H trials, respectively. These results suggest that exercise has little effect on postexercise gastric emptying rate of a glucose solution.