Do Current Pre-Exercise Fluid Recommendations for Athletes Need to be Updated? A Short Review Short Review

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Samantha Kostelnik
Melinda Valliant


Exercise, euhydration, sport, fluid protocol


Introduction: Maintaining adequate hydration throughout the day is extremely important, especially for the athletic population. While several recommendations have been developed to aid in timing (i.e., before, during and after exercise) and quantity of fluid intake, research has shown that approximately 70% of collegiate athletes arrive to practice in a dehydrated state. This review aims to identify the studies that have developed fluid protocols or utilized fluid recommendations for athletes prior to exercise.

Methods: Two databases and 13 search terms were used to find relevant articles.

Results: To date, several position papers, observational, and experimental (25 investigations total) studies that included a pre-exercise fluid recommendation and protocols to achieve euhydration were identified.

Conclusions: Many of the fluid recommendations and protocols identified are different and some are not supported with evidence. In addition, very few have utilized fluid recommendations based on body weight. Future research could further investigate the use of fluid protocols catered to body weight or based on other practical assessment methods, in an effort to make individualized hydration plans.

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1. Sawka MN, Wenger CB, Pandolf KB. Thermoregulatory responses to acute exercise-heat stress and heat acclimation. Compr Physiol. Published online December 1996:157-185. doi:10.1002/CPHY.CP040109
2. Jéquier E, Constant F. Water as an essential nutrient: The physiological basis of hydration. Eur J Clin Nutr. 2010;64(2):115-123. doi:10.1038/ejcn.2009.111
3. Popkin BM, D’anci KE, Rosenberg IH. Water, hydration, and health. Nutr Rev. Published online 2010. doi:10.1111/j.1753-4887.2010.00304.x
4. Belval LN, Hosokawa Y, Casa DJ, et al. Practical hydration solutions for sports. Nutrients. 2019;11(7). doi:10.3390/nu11071550
5. Hancock PA, Vasmatzidis I. Effects of heat stress on cognitive performance: The current state of knowledge. Int J Hyperth. 2003;19(3):355-372. doi:10.1080/0265673021000054630
6. Castro-Sepúlveda M, Cerda-Kohler H, Pérez-Luco C, et al. Hydration status after exercise affect resting metabolic rate and heart rate variability. Nutr Hosp. 2014;31(3):1273-1277. doi:10.3305/NH.2015.31.3.8523
7. McDermott BP, Anderson SA, Armstrong LE, et al. National athletic trainers’ association position statement: Fluid replacement for the physically active. J Athl Train. 2017;52(9):877-895. doi:10.4085/1062-6050-52.9.02
8. Maughan RJ, Shirreffs SM. Development of hydration strategies to optimize performance for athletes in high-intensity sports and in sports with repeated intense efforts. Scand J Med Sci Sport. 2010;20(SUPPL. 2):59-69. doi:10.1111/j.1600-0838.2010.01191.x
9. Thomas DT, Erdman KA, Burke LM. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016;116(3):501-528. doi:10.1016/j.jand.2015.12.006
10. Kostelnik SB, Rockwell MS, Davy KP, Hedrick VE, Travis Thomas D, Davy BM. Evaluation of pragmatic methods to rapidly assess habitual beverage intake and hydration status in U.S. collegiate athletes. Int J Sport Nutr Exerc Metab. 2021;31(2):115-124. doi:10.1123/IJSNEM.2020-0125
11. Kenefick RW, Cheuvront SN. Hydration for recreational sport and physical activity. Nutr Rev. 2012;70(suppl_2):S137-S142. doi:10.1111/J.1753-4887.2012.00523.X
12. Casa DJ, Armstrong LE, Hillman SK, et al. National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes. J Athl Train. 2000;35(2):212-224.
13. Armstrong LE, Maresh CM, Castellani JW, et al. Urinary indices of hydration status. Int J Sport Nutr. 1994;4(3):265-279. doi:10.1123/ijsn.4.3.265
14. Olzinski S, Beaumont J, Toledo M, Yudell A, Johnston CS, Wardenaar FC. Hydration status and fluid needs of division I female collegiate athletes exercising indoors and outdoors. Sports. 2019;7(7). doi:10.3390/sports7070155
15. Cheuvront S, Ely B, Kenefick R, Sawka M. Biological variation and diagnostic accuracy of dehydration assessment markers. Am J Clin Nutr. 2010;92(3):565-573. doi:10.3945/AJCN.2010.29490
16. Magal M, Cain RJ, Long JC, Thomas KS. Pre-practice hydration status and the effects of hydration regimen on collegiate division III male athletes. J Sport Sci Med. 2015;14(1):23-28.
17. Armstrong LE, Pumerantz AC, Fiala KA, et al. Human hydration indices: acute and longitudinal reference values. Int J Sport Nutr Exerc Metab. 2010;20(2):145-153. doi:10.1123/IJSNEM.20.2.145
18. Vescovi JD, Watson G. Variability of body mass and urine specific gravity in elite male field hockey players during a pre-olympic training camp. Int J Sport Nutr Exerc Metab. 2019;29(1):46-50. doi:10.1123/IJSNEM.2018-0121
19. Heishman AD, Daub BD, Miller RM, Freitas EDS, Bemben MG. Longitudinal Hydration Assessment in Collegiate Basketball Players Over Various Training Phases. J strength Cond Res. 2021;35(4):1089-1094. doi:10.1519/JSC.0000000000002845
20. Giersch GEW, Morrissey MC, Butler CR, et al. Sex difference in initial thermoregulatory response to dehydrated exercise in the heat. Physiol Rep. 2021;9(14). doi:10.14814/PHY2.14947
21. Sekiguchi Y, Benjamin CL, Butler CR, et al. The Relationship between %BML, Urine Color, Thirst Level and Urine Indices of Hydration Status. Ann Nutr Metab. 2020;76(1):65-66. doi:10.1159/000515217
22. O’Neal EK, Johnson SL, Davis BA, Pribyslavska V, Stevenson-Wilcoxson MC. Urine Specific Gravity as a Practical Marker for Identifying Suboptimal Fluid Intake of Runners ∼12-hr Postexercise. Int J Sport Nutr Exerc Metab. 2019;29(1):32-38. doi:10.1123/IJSNEM.2017-0383
23. Suh H, Lynndee, Summers G, et al. Afternoon urine osmolality is equivalent to 24 h for hydration assessment in healthy children. Eur J Clin Nutr. 2020;74:884-890. doi:10.1038/s41430-019-0519-5
24. Baker LB, Lang JA, Larry Kenney W. Change in body mass accurately and reliably predicts change in body water after endurance exercise. Eur J Appl Physiol. 2009;105(6):959-967. doi:10.1007/S00421-009-0982-0
25. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39(2):377-390. doi:10.1249/MSS.0B013E31802CA597
26. Armstrong LE, Herrera Soto JA, Hacker FT, Casa DJ, Kavouras SA, Maresh CM. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr Exerc Metab. 1998;8(4):345-355. doi:10.1123/ijsn.8.4.345
27. Greenleaf JE, Castle BL. Exercise temperature regulation in man during hypohydration and hyperhydration. J Appl Physiol. 1971;30(6):847-853. doi:10.1152/JAPPL.1971.30.6.847
28. Lee JKW, Shirreffs SM, Maughan RJ. Cold drink ingestion improves exercise endurance capacity in the heat. Med Sci Sports Exerc. 2008;40(9):1637-1644. doi:10.1249/MSS.0B013E318178465D
29. Maresh CM, Herrera-Soto JA, Armstrong LE, et al. Perceptual responses in the heat after brief intravenous versus oral rehydration. Med Sci Sports Exerc. 2001;33(6):1039-1045. doi:10.1097/00005768-200106000-00025
30. Casa DJ, Maresh CM, Armstrong LE, et al. Intravenous versus oral rehydration during a brief period: responses to subsequent exercise in the heat. Med Sci Sports Exerc. 2000;32(1):124-133. doi:10.1097/00005768-200001000-00019
31. Robinson TA, Hawley JA, Palmer Gary R Wilson GS, et al. Water ingestion does not improve 1-h cycling performance in moderate ambient temperatures. Eur J Appl Physiol Occup Physiol. 1995;71:153-160.
32. Goulet EDB, Rousseau SF, Lamboley CRH, Plante GE, Dionne IJ. Pre-exercise hyperhydration delays dehydration and improves endurance capacity during 2 h of cycling in a temperate climate. J Physiol Anthropol. 2008;27(5):263-271. doi:10.2114/JPA2.27.263
33. Riebe D, Maresh CM, Armstrong LE, et al. Effects of oral and intravenous rehydration on ratings of perceived exertion and thirst. Med Sci Sports Exerc. 1997;29(1):117-124. doi:10.1097/00005768-199701000-00017
34. Casa DJ, Stearns RL, Lopez RM, et al. Influence of Hydration on Physiological Function and Performance During Trail Running in the Heat. J Athl Train. 2010;45(2):147. doi:10.4085/1062-6050-45.2.147
35. Volpe SL, Poule KA, Bland EG. Estimation of prepractice hydration status of National Collegiate Athletic Association Division I athletes. J Athl Train. 2009;44(6):624-629. doi:10.4085/1062-6050-44.6.624
36. Convertino VA, Armstrong LE, Coyle EF, et al. ACSM Position Stand: Exercise and fluid replacement. Med Sci Sport Exerc. 1996;28(10).
37. Racinais S, Alonso JM, Coutts AJ, et al. Consensus recommendations on training and competing in the heat. Scand J Med Sci Sports. 2015;25 Suppl 1(S1):6-19. doi:10.1111/SMS.12467
38. Moroff S V., Bass DE. Effects of overhydration on man’s physiological responses to work in the heat. J Appl Physiol. 1965;20(2):267-270. doi:10.1152/JAPPL.1965.20.2.267
39. Goulet E. Dehydration and endurance performance in competitive athletes. Nutr Rev. 2012;70(SUPPL/2). doi:10.1111/j.1753-4887.2012.00530.x
40. Montain SJ, Coyle EF. Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. J Appl Physiol. 1992;73(4):1340-1350. doi:10.1152/JAPPL.1992.73.4.1340
41. Stover EA, Zachwieja J, Stofan J, Murray R, Horswill CA. Consistently high urine specific gravity in adolescent American football players and the impact of an acute drinking strategy. Int J Sports Med. 2006;27(4):330-335. doi:10.1055/s-2005-865667
42. Hamouti N, Del Coso J, Mora-Rodriguez R. Comparison between blood and urinary fluid balance indices during dehydrating exercise and the subsequent hypohydration when fluid is not restored. Eur J Appl Physiol. 2013;113(3). doi:10.1007/s00421-012-2467-9
43. Merry TL, Ainslie PN, Cotter JD. Effects of aerobic fitness on hypohydration-induced physiological strain and exercise impairment. Acta Physiol. 2010;198(2). doi:10.1111/j.1748-1716.2009.02051.x
44. Logan-Sprenger HM, Spriet LL. The acute effects of fluid intake on urine specific gravity and fluid retention in a mildly dehydrated state. J strength Cond Res. 2013;27(4):1002-1008. doi:10.1519/JSC.0B013E31826052C7
45. Benjamin CL, Sekiguchi Y, Morrissey MC, et al. The effects of hydration status and ice-water dousing on physiological and performance indices during a simulated soccer match in the heat. J Sci Med Sport. 2021;24(8):723-728. doi:10.1016/J.JSAMS.2021.05.013
46. Piet Van Rosendal S, Osborne MA, Fassett RG, Coombes JS. Guidelines for Glycerol Use in Hyperhydration and Rehydration Associated with Exercise. Sport Med. 2010;40(2):113-129. doi: 10.2165/11530760-000000000-00000
47. Kovacs MS. A review of fluid and hydration in competitive tennis. Int J Sports Physiol Perform. 2008;3(4):413-423. doi:10.1123/ijspp.3.4.413
48. Kiitam U, Voitkevica L, Timpmann S, et al. Pre-practice hydration status in soccer (football) players in a cool environment. Med. 2018;54(6). doi:10.3390/MEDICINA54060102
49. Emerson DM, Torres-McGehee TM, Emerson CC, LaSalle TL. Individual fluid plans versus ad libitum on hydration status in minor professional ice hockey players. J Int Soc Sports Nutr. 2017;14(1). doi:10.1186/s12970-017-0183-x
50. Cleary MA, Hetzler RK, Wasson D, Wages JJ, Stickley C, Kimura IF. Hydration behaviors before and after an educational and prescribed hydration intervention in adolescent athletes. J Athl Train. 2012;47(3):273-281. doi:10.4085/1062-6050-47.3.05
51. Osterberg KL, Horswill CA, Baker LB. Pregame urine specific gravity and fluid intake by national basketball association players during competition. J Athl Train. 2009;44(1):53-57. doi:10.4085/1062-6050-44.1.53

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