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Athletes are encouraged to begin exercise well hydrated and to consume sufficient amounts of appropriate fluids during exercise to limit water and salt deficits. Available evidence suggests that many athletes begin exercise already dehydrated to some degree, and although most fail to drink enough to match sweat losses, some drink too much and a few develop hyponatremia. Some simple advice can help athletes assess their hydration status and develop a personalized hydration strategy that takes account of exercise, environment, and individual needs. Preexercise hydration status can be assessed from urine frequency and volume, with additional information from urine color, specific gravity, or osmolality. Change in hydration during exercise can be estimated from the change in body mass that occurs during a bout of exercise. Sweat rate can be estimated if fluid intake and urinary losses are also measured. Sweat salt losses can be determined by collection and analysis of sweat samples, but athletes losing large amounts of salt are likely to be aware of the taste of salt in sweat and the development of salt crusts on skin and clothing where sweat has evaporated. An appropriate drinking strategy will take account of preexercise hydration status and of fluid, electrolyte, and substrate needs before, during, and after a period of exercise. Strategies will vary greatly between individuals and will also be influenced by environmental conditions, competition regulations, and other factors.

Water intake occurs following a period of high-intensity intermittent exercise (HIIE) due to sensations of thirst yet this does not always appear to be caused by body water losses. Thus, the aim was to assess voluntary water intake following HIIE. Ten healthy males (22 ± 2 y, 75.6 ± 6.9 kg, VO_2peak 57.3 ± 11.4 m·kg⁻¹·min⁻¹; mean± SD) completed two trials (7–14 d apart). Subjects sat for 30 min then completed an exercise period involving 2 min of rest followed by 1 min at 100% VO_2peak repeated for 60 min (HIIE) or 60 min continuously at 33% VO_2peak (LO). Subjects then sat for 60 min and were allowed ad libitum water intake. Body mass was measured at start and end of trials. Serum osmolality, blood lactate, and sodium concentrations, sensations of thirst and mouth dryness were measured at baseline, postexercise and after 5, 15, 30, and 60 min of recovery. Vasopressin concentration was measured at baseline, postexercise, 5 min, and 30 min. Body mass loss over the whole trial was similar (HIIE: 0.77 ± 0.50; LO: 0.85 ± 0.55%; p = .124). Sweat lost during exercise (0.78 ± 0.22 vs. 0.66 ± 0.26 L) and voluntary water intake during recovery (0.416 ± 0.299 vs. 0.294 ± 0.295 L; p < .05) were greater in HIIE. Serum osmolality (297 ± 3 vs. 288 ± 4mOsmol·kg⁻¹), blood lactate (8.5 ± 2.7 vs. 0.7 ± 0.4 mmol·L⁻¹), serum sodium (146 ± 1 vs. 143 ± 1 mmol·L⁻¹) and vasopressin (9.91 ± 3.36 vs. 4.43 ± 0.86 pg·ml⁻¹) concentrations were higher after HIIE (p < .05) and thirst (84 ± 7 vs. 60 ± 21) and mouth dryness (87 ± 7 vs. 64 ± 23) also tended to be higher (p = .060). Greater voluntary water intake after HIIE was mainly caused by increased sweat loss and the consequences of increased serum osmolality mainly resulting from higher blood lactate concentrations.

Weight categorized athletes use a variety of techniques to induce rapid weight loss (RWL) in the days leading up to weigh in. This study examined the fluid and electrolyte balance responses to 24-hr fluid restriction (FR), energy restriction (ER) and fluid and energy restriction (F+ER) compared with a control trial (C), which are commonly used techniques to induce RWL in weight category sports. Twelve subjects (six male, six female) received adequate energy and water (C) intake, adequate energy and restricted water (~10% of C; FR) intake, restricted energy (~25% of C) and adequate water (ER) intake or restricted energy (~25% of C) and restricted (~10% of C) water intake (F+ER) in a randomized counterbalanced order. Subjects visited the laboratory at 0 hr, 12 hr, and 24 hr for blood and urine sample collection. Total body mass loss was 0.33% (C), 1.88% (FR), 1.97% (ER), and 2.44% (F+ER). Plasma volume was reduced at 24 hr during FR, ER, and F+ER, while serum osmolality was increased at 24 hr for FR and F+ER and was greater at 24 hr for FR compared with all other trials. Negative balances of sodium, potassium, and chloride developed during ER and F+ER but not during C and FR. These results demonstrate that 24 hr fluid and/or energy restriction significantly reduces body mass and plasma volume, but has a disparate effect on serum osmolality, resulting in hypertonic hypohydration during FR and isotonic hypohydration during ER. These findings might be explained by the difference in electrolyte balance between the trials.

Exercising in cold environments results in water losses, yet examination of resultant voluntary water intake has focused on warm conditions. The purpose of the study was to assess voluntary water intake during and following exercise in a cold compared with a warm environment. Ten healthy males (22 ± 2 years, 67.8 ± 7.0 kg, 1.77 ± 0.06 m, VO_2peak 60.5 ± 8.9 ml·kg⁻¹·min⁻¹) completed two trials (7–8 days). In each trial subjects sat for 30 min before cycling at 70% VO_2peak (162 ± 27W) for 60 min in 25.0 ± 0.1 °C, 50.8 ± 1.5% relative humidity (RH; warm) or 0.4 ± 1.0 °C, 68.8 ± 7.5% RH (cold). Subjects then sat for 120 min at 22.2 ± 1.2 °C, 50.5 ± 8.0% RH. Ad libitum drinking was allowed during the exercise and recovery periods. Urine volume, body mass, serum osmolality, and sensations of thirst were measured at baseline, postexercise and after 60 and 120 min of the recovery period. Sweat loss was greater in the warm trial (0.96 ± 0.18 l v 0.48 ± 0.15 l; p < .0001) but body mass losses over the trials were similar (1.15 ± 0.34% (cold) v 1.03 ± 0.26% (warm)). More water was consumed throughout the duration of the warm trial (0.81 ± 0.42 l v 0.50 ± 0.49 l; p = .001). Cumulative urine output was greater in the cold trial (0.81 ± 0.46 v 0.54 ± 0.31 l; p = .036). Postexercise serum osmolality was higher compared with baseline in the cold (292 ± 2 v 287 ± 3 mOsm.kg⁻¹, p < .0001) and warm trials (288 ± 5 v 285 ± 4 mOsm·kg⁻¹; p = .048). Thirst sensations were similar between trials (p > .05). Ad libitum water intake adjusted so that similar body mass losses occurred in both trials. In the cold there appeared to a blunted thirst response.

To determine the effectiveness of 3 commonly used beverages in restoring fluid and electrolyte balance, 8 volunteers dehydrated by 1.94% ± 0.17% of body mass by intermittent exercise in the heat, then ingested a carbohydrate-electrolyte solution (Gatorade), carbonated water/apple-juice mixture (Apfelschorle), and San Benedetto mineral water in a volume equal to 150% body-mass loss. These drinks are all are perceived to be effective rehydration solutions, and their effectiveness was compared with the rehydration effectiveness of Evian mineral water, which is not perceived in this way by athletes. Four hours after rehydration, the subjects were in a significantly lower hydration status than the pretrial situation on trials with Apfelschorle (–365 ± 319 mL, P = 0.030), Evian (–529 ± 319 mL, P < 0.0005), and San Benedetto (–401 ± 353 mL, P = 0.016) but were in the same hydration status as before the dehydrating exercise on Gatorade (–201 ± 388 mL, P = 0.549). Sodium balance was negative on all trials throughout the study; only with Apfelschorle did subjects remain in positive potassium balance. In this scenario, recovery of fluid balance can only be achieved when significant, albeit insufficient, quantities of sodium are ingested after exercise. There is a limited range of commercially available products that have a composition sufficient to achieve this, even though the public thinks that some of the traditional drinks are effective for this purpose.

Previous investigations have suggested that exercise at intensities greater than 70% maximal oxygen uptake (VO_2max) 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.

This study measured fluid balance during a 90-min preseason training session in the first team squad (24 players) of an English Premier League football team. Sweat loss was assessed from changes in body mass after correction for ingested fluids and urine passed. Sweat composition was measured by collection from patches attached to the skin at 4 sites. The weather was warm (24-29 °C), with moderate humidity (46–64%). The mean ± SD body mass loss over the training session was 1.10 ± 0.43 kg, equivalent to a level of dehydration of 1.37 ± 0.54% of the pre-training body mass. Mean fluid intake was 971 ± 303 ml. Estimated total mean sweat loss was 2033 ±413 ml. Mean sweat electrolyte concentrations (mmol/L) were: sodium,49± 12; potassium,6.0± 1.3;chloride, 43 ± 10. Total sweat sodium loss of 99 ± 24 mmol corresponds to a salt (sodium chloride) loss of 5.8 ± 1.4 g. Mean urine osmolality measured on pre-training samples provided by the players was 666 ±311 mosmol/kg (n=21). These data indicate that sweat losses of water and solute in football players in training can be substantial but vary greatly between players even with the same exercise and environmental conditions. Voluntary fluid intake also shows wide inter-individual variability and is generally insufficient to match fluid losses.

This study investigated fluid and electrolyte balance in well-trained male and female swimmers during 2 training sessions. Participants were 17 nationally ranked swimmers measured during a period of intensive training. Sweat loss was assessed from changes in body mass after correction for fluid intake and urine collection. Sweat composition was measured from waterproof absorbent patches applied at 4 skin sites. Air and pool-water temperatures were 36 °C and 27.4 °C, respectively. Training lasted 105 min in each session. All measured variables were similar on the 2 testing days. Mean sweat-volume loss was 548 ± 243 ml, and mean sweat rate was 0.31 ± 0.1 L/hr. Mean fluid intake was 489 ± 270 ml. Mean body-mass loss was 0.10 ± 0.50 kg, equivalent to 0.1% ± 0.7% dehydration. Mean pretraining urine osmolality was 662 ± 222 mOsm/kg, which was negatively associated with both mean drink volume consumed (p = .044, r ² = .244) and mean urine volume produced during training (p = .002, r ² = .468). Mean sweat Na⁺, K⁺, and Cl⁻ concentrations (mmol/L) were 43 ± 14, 4 ± 1, and 31± 9, respectively; values were not different between males and females and were not different between days except for a marginal difference in K⁺ concentration. The average swimmer remained hydrated during the session, and calculated sweat rates were similar to those in previous aquatic studies.