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This study investigated whether different beverage carbohydrate concentration and osmolality would provoke gastrointestinal (GI) discomfort during intermittent, high-intensity exercise. Thirty-six adult and adolescent athletes were tested on separate days in a double-blind, randomized trial of 6% and 8% carbohydrate-electrolytes (CHO-E) beverages during four 12-min quarters (Q) of circuit training that included intermittent sprints, lateral hops, shuttle runs, and vertical jumps. GI discomfort and fatigue surveys were completed before the first Q and immediately after each Q. All ratings of GI discomfort were modest throughout the study. The cumulative index for GI discomfort, however, was greater for the 8% CHO-E beverage than for the 6% CHO-E beverage at Q3 and Q4 (P < 0.05). Averaging across all 4 quarters, the 8% CHO-E treatment produced significantly higher mean ratings of stomach upset and side ache. In conclusion, higher CHO concentration and osmolality in an ingested beverage provokes stomach upset and side ache.

The addition of carbohydrate and sodium to sport drinks has been recommended to enhance fluid intake and absorption and to delay fatigue. Other electrolytes (E) which are lost through sweating are also commonly added. However, too many E may lead to increased serum E and osmolality levels, which may negatively influence thermoregulation, depress sweating, and cause gastrointestinal distress. On the other hand, drinking large amounts of plain water to compensate sweat loss may induce hyponatremia. Therefore, literature describing sweat E losses was examined in order to estimate average whole-body E loss and to determine an upper limit for replacement of E with sport drinks. Mean E loss was determined from 13 studies, with +1 SD resulting in a hypothetical range for E losses. Correction for net absorption resulted in an upper limit of electrolyte replacement. It is suggested that the E levels in sport rehydration drinks should not exceed the upper limit of the range given.

Body water and electrolyte balance are essential to optimal physiological function and health. During exercise, work, or high temperatures, a significant level of dehydration can develop, and the ratio of extracellular to intracellular fluid can change, despite an ample supply of water. Physical and cognitive performance are impaired at 1-2% dehydration, and the body can collapse when water loss approaches 7%. Because fluid needs and intakes vary, formulating one general guideline for fluid replacement is difficult. Knowing the amount of water lost in sweat may enable predicting fluid needs via mathematical models for industrial, athletic, and military scenarios. Sodium imbalance might result from excessive Na⁺ loss or from gross o verity dration. In most work or exercise lasting < 3-4 hr, the major concern is that fluid be available to prevent heat-related illnesses, which can be prevented if fluid and electrolyte losses are balanced with intake, using the recommendations presented.

This article reviews studies, mostly from the authors' laboratory, on children's sweating rates and composition, voluntary drinking patterns during prolonged exercise in the heat, taste perception of beverages, and the importance of fluid flavor and composition in preventing voluntary dehydration. Subjects were children, exposed for 90 to 180 min to intermittent bouts of cycling (45-50% maximal ${\text{O}}_2$ uptake) in a climatic chamber (mostly at $35{}^{°}\text{C}$ , 40-50% relative humidity). There were five main findings: When given unflavored water ad libitum, children dehydrated progressively and their core temperature increased faster than in adults. When offered drinks with various flavors, children preferred grape to other flavors. When given grape-flavored water during intermittent exercise in the heat, children voluntarily drank 44.5% more than with unflavored water. When given grape-flavored carbohydrate-electrolyte solution, they voluntarily drank 91% more than with unflavored water. Finally, such consumption of carbohydrate-electrolyte solution was sufficient to prevent voluntary dehydration during 180-min intermittent exercise in the heat.

The effects of a commercial sports drink on performance in high-intensity cycling was investigated. Nine well-trained subjects were asked to complete a set amount of work as fast as possible (time trial) following 24 h of dietary (subjects were provided with food, energy 57.4 ± 2.4 kcal/kg and carbohydrate 9.1 ± 0.4 g/kg) and exercise control. During exercise, subjects were provided with 14 mL/kg of either 6% carbohydrate-electrolyte (CHO-E) solution or carbohydrate-free placebo (P). Results showed that subjects’ performances did not greatly improve (time, 62:34 ± 6:44 min:sec (CHO-E) vs. 62:40 ± 5:35 min:sec (P); average power output, 283.0 ± 25.0 W (CHO-E) vs. 282.9 ± 29.3 W (P), P > 0.05) while consuming the sports drink. It was concluded that CHO-E consumption throughout a 1-h time trial, following a pre-exercise dietary regimen designed to optimize glucose availability, did not improve time or power output to a greater degree than P in well-trained cyclists.