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Francesco Campa, Catarina N. Matias, Elisabetta Marini, Steven B. Heymsfield, Stefania Toselli, Luís B. Sardinha, and Analiza M. Silva

changes in body fluids, the methods are expensive, involving specialized technicians to perform and analyze the required exams. Yet, practitioners, coaches, and researchers face the common problem of a lack of valid and practical methods and techniques to monitor body fluids changes under various

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Javier Abian-Vicen, Adrián Castanedo, Pablo Abian, Cristina Gonzalez-Millan, Juan José Salinero, and Juan Del Coso

The aim was to analyze the influence of competitive round on muscle strength, body-fluid balance, and renal function in elite badminton players during a real competition. Body mass, jump height during a countermovement jump, handgrip force, and urine samples were obtained from 13 elite badminton players (6 men and 7 women) before and after the 2nd-round and quarterfinal matches of the national Spanish badminton championship. Sweat rate was determined by using prematch-to-postmatch body-mass change and by weighing individually labeled fluid bottles. Sweat rates were 1.04 ± 0.62 and 0.98 ± 0.43 L/h, while rehydration rate was 0.69 ± 0.26 and 0.91 ± 0.52 L/h for the 2nd round and quarterfinals, respectively. Thus, dehydration was 0.47% ± 1.03% after the 2nd round and 0.23% ± 0.43% after the quarterfinals. There were no differences in prematch-to-postmatch jump height, but jump height was reduced from 37.51 ± 8.83 cm after the 2nd-round game to 34.82 ± 7.37 cm after the quarterfinals (P < .05). No significant differences were found in handgrip force when comparing prepost matches or rounds, although there were significant differences between dominant and nondominant hands (P < .05). The succession of rounds caused the appearance of proteinuria, hematuria, glycosuria, and higher nitrite and ketone concentrations in urine. Rehydration patterns during a real badminton competition were effective to prevent dehydration. A badminton match did not affect jump height or handgrip force, but jump height was progressively reduced by the competitive round. Badminton players’ renal responses reflected diminished renal flux due to the high-intensity nature of this racket sport.

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Lawrence E. Armstrong

Recreational enthusiasts and athletes often are advised to abstain from consuming caffeinated beverages (CB). The dual purposes of this review are to (a) critique controlled investigations regarding the effects of caffeine on dehydration and exercise performance, and (b) ascertain whether abstaining from CB is scientifically and physiologically justifiable. The literature indicates that caffeine consumption stimulates a mild diuresis similar to water, but there is no evidence of a fluid-electrolyte imbalance that is detrimental to exercise performance or health. Investigations comparing caffeine (100-680 mg) to water or placebo seldom found a statistical difference in urine volume. In the 10 studies reviewed, consumption of a CB resulted in 0-84% retention of the initial volume ingested, whereas consumption of water resulted in 0-81% retention. Further, tolerance to caffeine reduces the likelihood that a detrimental fluid-electrolyte imbalance will occur. The scientific literature suggests that athletes and recreational enthusiasts will not incur detrimental fluid-electrolyte imbalances if they consume CB in moderation and eat a typical U.S. diet. Sedentary members of the general public should be at less risk than athletes because their fluid losses via sweating are smaller.

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Ronald J. Maughan, Lisa A. Dargavel, Rachael Hares, and Susan M. Shirreffs

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.

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Beatriz Rael, Nuria Romero-Parra, Víctor M. Alfaro-Magallanes, Laura Barba-Moreno, Rocío Cupeiro, Xanne Janse de Jonge, Ana B. Peinado, and on Behalf of the IronFEMME Study Group

, and adipose tissue, that have sex hormone receptors. 1 Thus, these sex hormones may also impact other physiological systems, such as body fluid regulation, sodium content, 1 and metabolic homeostasis. 2 The natural menstrual cycle (MC) is a cyclic process controlled by the hypothalamus

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Matthew S. Hickey, David L. Costill, and Scott W. Trappe

This study investigated the influence of drink carbonation and carbohydrate content on ad libitum drinking behavior and body fluid and electrolyte responses during prolonged exercise in the heat. Eight competitive male runners completed three 2-hr treadmill runs at 60% VO2max in an environmental chamber maintained at 30 C° and 40% RH. Three test drinks were used: 8% carbohydrate, low carbonation (8%-C); 8% carbohydrate, noncarbonated (8%-NC), and water (0%-NC). Blood samples were taken preexercise (0), at 60 and 120 min of exercise, and at 60 min of recovery (+60 min). The data suggest that while reports of heartburn tend to be higher on 8% carbohydrate drinks than on 0%-NC, this does not appear to be a function of drink carbonation. Similarly, the increased frequency of heartbum did not significantly reduce fluid consumption either during exercise or during a 60-min recovery period. Importantly, no differences were observed between fluid and electrolyte, or thermoregulatory responses to the three sport drinks. Thus, consumption of low-carbonation beverages does not appear to significantly influence drinking behavior or the related physiological responses during prolonged exercise in the heat.

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Richard D. Wemple, Tamara S. Morocco, and Gary W. Mack

This study investigated the hypothesis that addition of Na+ to a rehydration beverage would stimulate drinking and augment restoration of body water in individuals dehydrated during 90 min of continuous treadmill exercise in the heat. Following a 3.0 ± 0.2% decrease in body weight (BW), 6 subjects sat in a thermoneutral environment for 30 min to allow body fluid compartments to stabilize. Over the next 3 hr, subjects rehydrated ad libitum using either flavored/artificially sweetened water (H20-R) or a flavored, 6% sucrose drink containing either 25(LNa+R) or 50 HNa+R mmol/L NaCl. Results demonstrated that rapid removal of the osmotic stimulus, during H20-R, and the volume-dependent dipsogenic stimuli, during HNa+R, are important factors in limiting fluid intake during rehydration, compared to LNa+R. It was also found that the pattern of fluid replacement and restoration of fluid balance following dehydration is influenced by the dehydration protocol used to induce the loss in total body water and the sodium content of the rehydration beverage.

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Stephen Heung-Sang Wong and Feng-Hua Sun

The purpose of the current study was to examine the effect of flavor on voluntary drinking and thermoregulatory responses in Chinese boys and girls exercising intermittently in a hot environment. Fourteen boys and girls (9 to 11 years old) performed four 3-hour intermittent exercise sessions (20-min walking sessions at 50% VO2peak followed by a 25-minute rest period) in a hot and humid environment (~30 °C ambient temperature and ~70% relative humidity). The participants consumed 1 of 4 beverages ad libitum in a randomized sequence by using a Latin-square principle: unflavored water (W), orange-flavored water (OF), lemon-flavored water (LF), and grape-flavored water (GF). No differences were observed in the total fluid intake (W vs. OF vs. LF vs. GF: Boys, 441 ± 114 vs. 493 ± 106 vs. 387 ± 83 vs. 568 ± 146 ml; Girls, 613 ± 131 vs. 923 ± 204 vs. 825 ± 157 vs. 790 ± 166 ml), urine and sweat output, and physiological perceptual variables among trials and between sexes. The results suggested that Chinese children can maintain body fluid balance while exercising moderately in a hot and humid environment by ad libitum drinking. The flavor of the beverages had no impact on the voluntary drinking and the state of hydration in the current study.

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Michelle R. Minehan, Malcolm D. Riley, and Louise M. Burke

A palatable flavor is known to enhance fluid intake during exercise; however, a fear of excessive kilojoule intake may deter female athletes from consuming a sports drink during training sessions. In order to examine this issue, we monitored fluid balance during 9 separate training sessions undertaken by junior elite female netball players (n = 9), female basketball players (n = 7), and male basketball players (n = 8). The beverages tested were water, a regular carbohydrate-electrolyte beverage (6.8% CHO, 18.7 mmol/L Na, 3.0 mmol/L K, 1130 kJ/L), and an identical tasting, low kilojoule electrolyte beverage (1% CHO, 18.7 mmol/L Na, 3.0 mmol/L K, 170 kJ/L). Each subject received each of the 3 drinks at 3 separate training sessions, in a randomized, balanced order. Subjects were aware of the beverage provided. Change in body mass over the training session was used to estimate body fluid change, while voluntary fluid intake was determined from the change in weight of drink bottles used in each session. The overall fluid balance on drinks classified as regular, low kilojoule, and water was -11.3 ml/h (95%CI -99.6 to 77.0), -29.5 ml/h (95%CI -101.4 to 42.5) and -156.4 ml/h (95%CI -215.1 to -97.6), respectively. The results indicate that, overall, better fluid balance was achieved using either of the flavored drinks compared to water. These data confirm that flavored drinks enhance fluid balance in a field situation, and suggest that the energy content of the drink is relatively unimportant in determining voluntary fluid intake.

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Beat Knechtle, Patrizia Knechtle, and Thomas Rosemann


Fluid overload is considered a main risk factor for exercise-associated hyponatremia (EAH). The aim of this study was to investigate the incidence of EAH in ultra-runners at the 100 km ultra-run in Biel, Switzerland.


Pre- and postrace, body mass, urinary specific gravity, hemoglobin, hematocrit, plasma [Na+], and plasma volume were determined.


Of the 145 finishers, seven runners (4.8%) developed asymptomatic EAH. While running, the athletes consumed a total of (median and interquartile ranges) 6.9 (5.1-8.8) L over the 100 km distance, equal to 0.58 (0.41-0.79) L/h. Fluid intake correlated negatively and significantly with race time (r = -.50, P < .0001). Body mass decreased, plasma [Na+] remained unchanged, hematocrit and hemoglobin decreased, and urinary specific gravity increased. Plasma volume increased by 4.6 (-2.3 to 12.8) %. Change in body mass correlated with both postrace plasma [Na+] and Δ plasma [Na+]. Postrace plasma [Na+] correlated to Δ plasma [Na+]. Fluid intake was associated neither with postrace plasma [Na+] nor with Δ plasma [Na+]. Fluid intake was related to Δ body mass (r = .21, P = .012), but not to postrace body mass. Fluid intake showed no correlation to Δ plasma volume. Change in plasma volume was associated with postrace [Na+].


Incidences of EAH in 100 km ultra-marathoners were lower compared with reports on marathoners. Body mass decreased, plasma volume increased, and plasma [Na+] was maintained. Since fluid intake was related neither to Δ plasma volume nor to Δ plasma [Na+], we assume that factors other than fluid intake maintained body fluid homeostasis.