Current concepts concerning thirst, dehydration, and fluid replacement: overview.

For healthy endurance athletes, two potentially life-threatening medical emergencies are dehydration-mediated heat injuries and hyponatremia. Likewise, dehydration reduces exercise performance via thermoregulatory and cardiovascular impairment as well as electrolyte imbalances. Authors of this symposium integrate new research findings with established concepts concerning the development of dehydration (body water deficit), the physiological and medical consequences of fluid imbalance, and fluid (volume and composition) replacement strategies that minimize the risk of medical emergencies and optimize exercise performance. The following papers provide the readers with an appreciation of the historical development of current concepts and offer an informed opinion concerning fluid replacement strategies for a variety of work performance athletic events.     

Water and electrolyte requirements for exercise.

Exercise performance can be compromised by a body water deficit, particularly when exercise is performed in hot climates. It is recommended that individuals begin exercise when adequately hydrated. This can be facilitated by drinking 400 mL to 600 mL of fluid 2 hours before beginning exercise and drinking sufficient fluid during exercise to prevent dehydration from exceeding 2% body weight. A practical recommendation is to drink small amounts of fluid (150-300 mL) every 15 to 20 minutes of exercise, varying the volume depending on sweating rate. Core temperature, heart rate, and perceived effort remain lowest when fluid replacement comes closest to matching the rate of sweat loss. During exercise lasting less than 90 minutes, water alone is sufficient for fluid replacement. During prolonged exercise lasting longer than 90 minutes, commercially available carbohydrate electrolyte beverages should be considered to provide an exogenous carbohydrate source to sustain carbohydrate oxidation and endurance performance. Electrolyte supplementation is generally not necessary because dietary intake is adequate to offset electrolytes lost in sweat and urine; however, during initial days of hot-weather training or when meals are not calorically adequate, supplemental salt intake may be indicated to sustain sodium balance.     

Fluid ingestion does not influence intense 1-h exercise performance in a mild environment

PURPOSE: It is generally recommended that fluid be ingested during exercise at a rate that prevents body mass loss and prevents dehydration. It is, however, not known whether these recommendations are valid during intense endurance exercise in a mild environment. The purpose of this study was to examine the effect of fluid ingestion volume on heart rate (HR), rectal temperature, plasma electrolytes, and performance during intense endurance exercise at 21 degrees C. METHODS: Eight well-trained men (26+/-1 yr; 79.6+/-3.5 kg; VO2peak = 5.05+/-0.17 L.min(-1) ; mean+/-SEM) cycled for 45 min at 80+/-1% VO2peak while receiving either no fluid replacement (NF), a volume of water that prevented body mass loss (FR-100 = 1.47+/-0.05 L), or 50% of this volume (FR-50 = 0.72+/-0.03 L). The 45-min exercise bout was followed immediately by a 15-min "all-out" performance ride. RESULTS: NF was associated with a 1.9+/-0.0% body mass loss, while FR-50 and FR-100 resulted in losses of 1.0 = 0.1% and 0.0+/-0.1%, respectively. Although values tended to be higher in NF, fluid ingestion had no significant effect on HR or rectal temperature during exercise. Reductions in plasma volume and increases in plasma sodium and potassium concentrations during exercise were largely unaffected by fluid ingestion. RPE increased to a similar extent during exercise in the three trials while a mild increase in the degree of stomach bloating/fullness was evident in FR-100. Work completed during the 15-min performance ride was similar in the three trials (NF: 273+/-8, FR-50: 267+/-8, FR-100: 269+/-9 kJ). CONCLUSIONS: There appears to be little benefit from ingesting water during intense 1-h cycling exercise in mild environmental conditions since such ingestion has no significant effect on HR, body temperature, plasma volume, plasma electrolytes, or performance.     

Fluid replacement and performance during the marathon

The primary purpose of this review is to relate a universal strategy for replacing fluids to optimise marathon performance. A secondary purpose is to examine common 'matters of debate' that may modify fluid needs to include the importance of realistic convective air flow, metabolic water production and waters of association with glycogen. The metabolic demands of marathon running can result in substantial sweat losses and levels of dehydration consistent with compromised endurance performance. Recommendations are provided to individualise fluid intakes with the goal of preventing excessive dehydration (>2% body mass) as well as weight gain. The minor importance of 'matters of debate' to fluid replacement is also discussed.     

American College of Sports Medicine position stand. Exercise and fluid replacement

This Position Stand provides guidance on fluid replacement to sustain appropriate hydration of individuals performing physical activity. The goal of prehydrating is to start the activity euhydrated and with normal plasma electrolyte levels. Prehydrating with beverages, in addition to normal meals and fluid intake, should be initiated when needed at least several hours before the activity to enable fluid absorption and allow urine output to return to normal levels. The goal of drinking during exercise is to prevent excessive (>2% body weight loss from water deficit) dehydration and excessive changes in electrolyte balance to avert compromised performance. Because there is considerable variability in sweating rates and sweat electrolyte content between individuals, customized fluid replacement programs are recommended. Individual sweat rates can be estimated by measuring body weight before and after exercise. During exercise, consuming beverages containing electrolytes and carbohydrates can provide benefits over water alone under certain circumstances. After exercise, the goal is to replace any fluid electrolyte deficit. The speed with which rehydration is needed and the magnitude of fluid electrolyte deficits will determine if an aggressive replacement program is merited.     

Hydration recommendations for sport 2008

Fluid replacement remains an important strategy for preserving exercise performance as dehydration in excess of 2% of body weight consistently impairs aerobic exercise performance. Too much of a good thing, however, can have negative health consequences as persistent drinking in excess of sweating rate can induce symptomatic exercise associated hyponatremia. This short review highlights new position stands and/or policy statements regarding fluid replacement for sport, evidence that laboratory findings translate to team sport performance, and current hydration practices of athletes. It is culminated with practical strategies for drinking appropriately during physical activity.     

Intravenous versus oral rehydration during a brief period: responses to subsequent exercise in the heat

PURPOSE: The purpose of this study was to assess whether a brief period (20 min) of intravenous (i.v.) fluid rehydration versus oral rehydration differentially affects cardiovascular, thermoregulatory, and performance factors during exhaustive exercise in the heat. METHODS: Following dehydration (-4% of body weight), eight nonacclimated highly trained cyclists (age = 23.5 +/- 1.2 yr; VO2peak = 61.4 +/- 0.8 mL x kg x min(-1); body fat = 13.5 +/- 0.6%) rehydrated and then cycled at 70% VO2peak to exhaustion in 37 degrees C. Rehydration (randomized, cross-over design) included: 1) CONTROL (no fluid), 2) DRINK (oral rehydration, 0.45% NaCl) equal to 50% of prior dehydration, and 3) IV (intravenous rehydration, 0.45% NaCl), equal to 50% of prior dehydration. Thus, in the DRINK and IV treatments subjects began exercise (EX) at -2% of body weight. RESULTS: Exercise time to exhaustion was not different (P = 0.07) between DRINK (34.9 +/- 4 min) and IV (29.5 +/- 3.5 min), but both were significantly (P < 0.05) longer than CONTROL (18.9 +/- 2.7 min). Plasma volume was better (P < 0.05) restored during IV than CONTROL and DRINK at pre-exercise and 5 min EX, but different (P < 0.05) from only CONTROL at 15 min EX. Plasma lactate during DRINK was lower (P < 0.05) than IV at 15 min EX and postexercise. Heart rate during CONTROL was greater (P < 0.05) than DRINK and IV from 0-8 min EX, and greater (P < 0.05) than DRINK from 10-14 min EX. Rectal temperature during DRINK was less (P < 0.05) than IV from 0-24 min EX. Mean weighted skin temperature during DRINK was less (P < 0.05) than IV from 4-12 min EX. CONCLUSIONS: Thus, despite no statistically significant performance differences between DRINK and IV, it appears that certain physiological parameters were better maintained in the DRINK trial, and the trend toward performance differences may be important to elite athletes.     

No changes in time trial performance of master endurance athletes after 4 weeks on a low carbohydrate diet

The purpose of the present study was to evaluate the effects of a 4-week low-carbohydrate (CHO) diet regimen on body weight, exercise performance and hormonal response to running in master athletes. Six endurance master athletes performed three 30-min time trials, before (TT1), after 15 days (TT2) and after 30 days (TT3) on a low CHO diet. Blood samples were collected for hormonal and lactate measurements. After 15 days body weight had decreased (TT1 72.3 ± 2.4 kg, TT2 70.0 ± 2.7 kg; P = 0.006) and then remained stable. No differences were observed in performance (TT1 7,015 ± 273 m, TT2 6,920 ± 286 m, TT3 7,202 ± 315 m) and in the insulin/glucagon ratio. After 2 and 4 weeks, adrenocorticotropic hormone decreased significantly both at rest (baseline: TT1 42.5 ± 7.8 pg·ml^?1, TT3 21.6 ± 3.2 pg·ml^?1) and during exercise (end of exercise: TT1 120 ± 20 pg·ml^?1, TT2 80 ± 16 pg·ml^?1, TT3 31 ± 2 pg·ml^?1). Baseline cortisol concentrations had increased significantly after as little as 15 days on the low CHO diet. The results of the present study demonstrate no changes in time trial performance in master endurance athletes after 4 weeks on a low CHO diet. However, an effect on the hypothalamic pituitary adrenal axis emerged.     

The hydration and electrolyte maintenance properties of an experimental sports drink.

Seven highly trained subjects underwent exercise dehydration without fluid replacement (X), resulting in approximately 1.9% and approximately 3.5% body weight (fluid) losses at one and two hours, respectively. Subsequently, subjects underwent two identical exercise trials with isovolumetric fluid replacement of water (W) and an experimental formulation (Q). An anti-dehydration schedule was initiated prior to, and continued throughout the exercise, with W and Q supplied every 15 minutes at 16 degrees C in volumes related to each subject's fluid loss estimate derived from trial X. A rehydration schedule was maintained for two hours of recovery, with total fluid replacement equivalent to the body weight decrement due to fluid losses. In both W and Q trials, selected physiological indices of work performance were maintained closer to homeostatic levels during exercise, with a more rapid return to pre-exercise resting levels during recovery than during that trial X. Furthermore, W and Q were equally effective in preventing plasma volume changes during exercise and restoration to pre-exercise levels during recovery, as well as in preventing plasma osmolality disturbances during exercise and recovery, although minimal plasma electrolyte changes were associated with Q.     

Personalized fluid and fuel intake for performance optimization in the heat

It is well appreciated that a loss of body water (dehydration) can impair endurance performance and that the effect is magnified by environmental heat stress. A majority of professional sports medicine and nutrition organizations recommend drinking during exercise to replace sweat losses and prevent dehydration, while also avoiding frank over-hydration. Knowledge of sweating rate, which is highest in the heat for any given metabolic rate, is therefore considered key to developing a sound drinking strategy. Exercise duration and the provision of liquid fuel interacts with required drink volumes in important ways that are infrequently discussed but are of utmost practical concern. This review details some challenges related to the optimized coupling of fluid and fuel needs during prolonged exercise in the heat and the need for personalization.     

Joint Position Statement: nutrition and athletic performance. American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of food and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This position paper reviews the current scientific data related to the energy needs of athletes, assessment of body composition, strategies for weight change, the nutrient and fluid needs of athletes, special nutrient needs during training, the use of supplements and nutritional ergogenic aids, and the nutrition recommendations for vegetarian athletes. During times of high physical activity, energy and macronutrient needs-especially carbohydrate and protein intake-must be met in order to maintain body weight, replenish glycogen stores, and provide adequate protein for building and repair of tissue. Fat intake should be adequate to provide the essential fatty acids and fat-soluble vitamins, as well as to help provide adequate energy for weight maintenance. Overall, diets should provide moderate amounts of energy from fat (20% to 25% of energy); however, there appears to be no health or performance benefit to consuming a diet containing less than 15% of energy from fat. Body weight and composition can affect exercise performance, but should not be used as the sole criterion for sports performance; daily weigh-ins are discouraged. Consuming adequate food and fluid before, during, and after exercise can help maintain blood glucose during exercise, maximize exercise performance, and improve recovery time. Athletes should be well-hydrated before beginning to exercise; athletes should also drink enough fluid during and after exercise to balance fluid losses. Consumption of sport drinks containing carbohydrates and electrolytes during exercise will provide fuel for the muscles, help maintain blood glucose and the thirst mechanism, and decrease the risk of dehydration or hyponatremia. Athletes will not need vitamin and mineral supplements if adequate energy to maintain body weight is consumed from a variety of foods. However, supplements may be required by athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume high-carbohydrate diets with low micronutrient density. Nutritional ergogenic aids should be used with caution, and only after careful evaluation of the product for safety, efficacy, potency, and whether or not it is a banned or illegal substance. Nutrition advice, by a qualified nutrition expert, should only be provided after carefully reviewing the athlete's health, diet, supplement and drug use, and energy requirements.     

Effects of dehydration and fluid ingestion on cognition

The effects of exercise-induced dehydration and fluid ingestion on men's cognitive performance were assessed. Eleven young men attended separate sessions in which each individual cycled in a controlled environment at 60 % of V.O (2max) for periods of 15, 60, or 120 min without fluid replacement or 120 min with fluid replacement. Immediately following the assigned submaximal exercise period, the participant completed a graded exercise test to voluntary exhaustion. An executive processing test and a short-term memory test were performed prior to and immediately following exercise. Choice-response times during the executive processing test decreased following exercise, regardless of the level of dehydration. Choice-response errors increased following exercise, but only on trials requiring set shifting. Short-term memory performance improved following exercise, regardless of the level of dehydration. Changes in cognitive performance following exercise are hypothesized to be related to metabolic arousal following strenuous physical activity.     

Fluid replacement requirements for child athletes

Thermoregulatory responses to exercise differ in prepubertal athletes compared with their adult counterparts. It is important, therefore, to consider fluid requirements specific to this age group to prevent risks of dehydration and diminished sports performance. Relative to their body size, children demonstrate lower sweat water losses during exercise than adults. Nonetheless, percentage levels of incurred dehydration are similar in pre- and postpubertal athletes. Moreover, voluntary (ad libitum) drinking volumes in children in respect to their body size are comparable or greater than those of adults. Given an adequate opportunity to drink during exercise, volume intake driven by thirst should be expected to prevent significant levels of dehydration in child athletes. The amount can be calculated conservatively as an hourly fluid intake of 13 mL/kg (6 mL/lb) bodyweight. Equally important is post-exercise fluid replenishment (approximately 4 mL/kg [2 mL/lb] for each hour of exercise) to avoid initiating subsequent exercise bouts in a dehydrated state. Choice of fluid should be dictated by taste preference, since volume of intake, rather than fluid content, is the most critical issue in child athletes. Since children may lack motivation for proper fluid intake behaviours, the responsibility falls to coaches and parents to assure that young athletes receive appropriate hydration during and after exercise bouts.     

Exercise capacity and nitrogen loss during a high or low carbohydrate diet

Twelve obese women completed a maximal and an endurance exercise test (70% peak VO2) during a weight maintenance week. For the next 4 wk, the women consumed either a high (71%) carbohydrate (HC) or a low (33%) carbohydrate (LC), isonitrogenous very-low-calorie diet (VLCD) of 2,219 kJ (530 kcal).d-1. A supervised exercise session at 60% peak VO2 took place 3 times.wk-1 for 30 to 45 min. Peak VO2 and exercise endurance tests were repeated during the fourth week of the VLCD. One week of a 4,186 kJ (1000 kcal) diet followed the VLCD. The average weekly weight loss was 1.7 +/- 0.1 kg for the HC group and 2.0 +/- 0.2 kg for the LC group. Urinary nitrogen loss was greater for the LC group early in the VLCD but not different than HC over the entire experimental period. Serum cholesterol and high-density lipoprotein-cholesterol decreased in both groups but the ratio of these lipids improved over the treatment. Serum beta-hydroxybutyrate and uric acid increased significantly more for the LC than the HC group. Although absolute peak VO2 decreased, VO2 relative to body weight was maintained. Time to exhaustion improved by 36% for both groups in the endurance exercise tests. The endurance exercise R ratio was significantly more depressed by the LC than the HC treatment. In summary, both supervised treatments were effective in causing substantial weight reduction and improved blood lipid profiles in healthy young women but caused a net loss of body protein. Neither treatment compromised ability to participate in a thrice weekly exercise program. Although peak aerobic capacity did not increase, aerobic endurance at a fixed sub-maximal exercise load was improved.     

Effects of different sodium concentrations in replacement fluids during prolonged exercise in women

OBJECTIVE: To investigate the effect of different sodium concentrations in replacement fluids on haematological variables and endurance performance during prolonged exercise. METHODS: Thirteen female endurance athletes completed three four hour runs on a 400 m track. Environmental conditions differed between the three trials: 5.3 degrees C and snow (trial 1), 19.0 degrees C and sunny weather (trial 2), 13.9 degrees C and precipitation (trial 3). They consumed 1 litre of fluid an hour during the trials with randomised intake of fluids: one trial (H) with high sodium concentration (680 mg/l), one trial (L) with low sodium concentration (410 mg/l), and one trial with only water (W). Before and after the trials, subjects were weighed and blood samples were taken for analysis of [Na(+)](plasma), packed cell volume, and mean corpuscular volume. RESULTS: The mean (SD) decrease in [Na(+)](plasma) over the whole trial was significantly (p<0.001) less in trial H (2.5 (2.5) mmol/l) than in trial W (6.2 (2.1) mmol/l). Mild hyponatraemia ([Na(+)](plasma) = 130-135 mmol/l) was observed in only six women (46%) in trial H compared with nine (69%) in trial L, and 12 (92%) in trial W. Two subjects (17%) in trial W developed severe hyponatraemia ([Na(+)](plasma)<130 mmol/l). No significant differences were found in performance or haematological variables with the three different fluids. There was no significant correlation between[Na(+)](plasma) after the run and performance. There was a significant correlation between changes in [Na(+)](plasma) and changes in body weight. CONCLUSIONS: Exercise induced hyponatraemia in women is likely to develop from fluid overload during prolonged exercise. This can be minimised by the use of replacement fluids of high sodium concentration. Sodium replacement of at least 680 mg/h is recommended for women in a state of fluid overload during endurance exercise of four hours. However, higher [Na(+)](plasma) after the run and smaller decreases in [Na(+)](plasma) during the trials were no indication of better performance over four hours.     

Maintenance of plasma volume and serum sodium concentration despite body weight loss in ironman triathletes.

OBJECTIVE: To examine the relationship between body weight, plasma volume, and serum sodium concentration ([Na]) during prolonged endurance exercise. DESIGN: Observational field study. SETTINGS: 2000 South African Ironman Triathlon. PARTICIPANTS: 181 male triathletes competing in an Ironman triathlon. MAIN OUTCOME MEASURES: Body weight, plasma volume, and serum ([Na]) change from pre- to postrace. RESULTS: Significant body weight loss occurred (-4.9 +/- 1.7%; P < 0.0001), while both plasma volume (1.0 +/- 11.2%; P = 0.4: NS) and serum [Na] (0.6 +/- 2.4%; P < 0.001) increased from pre- to postrace. Blood volume (-0.6 +/- 6.6%) and red cell volume (-2.6 +/- 5.5%; P < 0.001) decreased in conjunction with the body weight loss. There was a strong correlation between blood and plasma volume change, both as a percentage, and absolute change in fluid volume (r = 0.9; P < 0.001). Body weight change was positively correlated with plasma volume change (r = -0.4; P < 0.001), but inversely correlated with serum [Na] change (r = -0.4; P < 0.001). Plasma volume change was not significantly correlated with serum [Na] change (r = 0.0; NS). Serum [Na] change was inversely correlated with both percentage of red cell volume change (r = -0.2; P < 0.05) and percentage body weight change (r = -0.4; P < 0.001). CONCLUSION: Plasma volume and serum [Na] were maintained in male Ironman triathletes, despite significant (5%) body weight loss during the course of the race. Body weight was not an accurate "absolute" surrogate of fluid balance homeostasis during prolonged endurance exercise. Clinicians should be warned against viewing these three regulatory parameters as interchangeable during an Ironman triathlon.     

Sodium-facilitated hypervolemia, endurance performance, and thermoregulation

The purpose of this study was to investigate the effects of an immediate pre-exercise, orally ingested, sodium load (164 mEq Na+) (IPOSL), equivalent to 10 ml per kilogram of body weight, on plasma volume, endurance performance, and thermoregulation. Fourteen male participants consumed a nearly isotonic (255 mOsm . kg (-1)) IPOSL and a hypotonic (94 mOsm . kg (-1)), no-sodium, placebo beverage (Pl) equivalent to 10 ml . kg (-1) body weight in a randomized design. Subjects cycled at 70 % of maximal work rate, in a 21.0 - 23.3 degrees C lab, for 45 min while cardiovascular and thermoregulatory variables were measured. This was followed by a 15-min performance time trial. IPOSL and Pl ingestion lead to a 3.1 % expansion and a 4.7 % reduction in resting baseline plasma volume, respectively. IPOSL maintained plasma volume during exercise to a greater extent than the Pl at 15 and 30, but not 45 min. There was a significant improvement ( approximately 7.8 %; p < 0.05) in time trial performance following IPOSL. No significant differences were observed for heart rate, core temperature, rate of perceived exertion or total body sweat rate (p > 0.05). In conclusion, IPOSL ingestion increased pre-exercise plasma volumes, maintained 15- and 30-min exercise plasma volumes, and improved an endurance performance time trial better than the Pl with no apparent compromise in thermoregulation.     

Regulation of MAC-1 (CD11b/CD18) expression on circulating granulocytes in endurance runners

PURPOSE: We tested the hypothesis that degranulation of granulocytes and upregulation of the granulocyte integrin MA-1 (CD11b/CD18) are related to exercise duration and/or intensity. We also investigated whether or not the expression of MAC-1 would be influenced by body temperature or dehydration. Moreover, we tested the hypothesis that changes in leukocyte counts and changes in MAC1 expression with endurance exercise are independently regulated. METHODS: In eight amateur runners, MAC-1 (CD11b/CD18) surface expression on granulocytes was determined by fluorescent antibody cell sorting, before and after an incremental maximal treadmill test, a moderate 3-h run, and a competitive marathon race. RESULTS: Expression CD11b on granulocytes was increased by 10+/-9.6% (P < 0.05) after the maximal treadmill test and by 84+/-76% (P < 0.01) after the marathon run. There was no change in CD11b expression after the moderate 3-h run. CD18 expression was not significantly changed after any of the exercise protocols. CONCLUSION: Expression of CD11b on granulocytes is increased with intense endurance exercise, either incremental maximal treadmill testing or competitive marathon running, but not in moderate endurance training. Thus, exhaustive exercise may be one mechanism for the upregulation of integrin adhesive receptors on granulocytes. This phenomenon could be in part responsible for increased adhesion of granulocytes to endothelial cells and could facilitate tissue infiltration after endurance exercise.     

Optimal use of fluids of varying formulations to minimise exercise-induced disturbances in homeostasis

The rationale underlying the development of various formulations of beverages for consumption before, during, and/or after physical exercise is that such formulations should minimise some of the disturbances in physiological homeostasis that occur during exercise and thereby prevent injury and/or enhance performance. Exercise- and dehydration-induced increases in core temperature, body fluid osmolality, heart rate, losses of plasma and other body fluid volumes, and carbohydrate depletion are probably the most important homeostatic disturbances that can be ameliorated by fluid consumption. With the exception of athletes subject to hyponatraemia after consumption of ordinary water during prolonged activity, changes in electrolyte concentrations in the body fluids of most athletes do not justify the inclusion of electrolytes in fluid replacement beverages to be consumed during exercise. However, small amounts of sodium added to water does speed gastric emptying and fluid absorption from the intestine. Recent evidence suggests that a precompetition meal high in easily digested carbohydrates should be consumed not later than 5 to 6 hours before competition. There is little published research on the optimal composition of this meal. Water ingestion 30 to 60 minutes before exercise seems to be of benefit to temperature regulation and cardiovascular homeostasis if the exercise is of moderate intensity (50 to 65% VO2max), but probably has little effect at the higher intensities of athletic performance. There is no systematic evidence to support the inclusion of calcium or sodium chloride in drinks consumed an hour or 2 before exercise. Furthermore, if glucose solutions are fed 15 to 45 minutes before prolonged exercise, they will probably cause a fall in blood glucose during exercise and may adversely affect performance. These adverse effects are not present when fructose is consumed before exercise. Contrary to the adverse effects of glucose feedings 15 to 60 minutes before exercise, the consumption of 18 to 50% solutions of glucose or glucose polymers 5 minutes before prolonged exercise seems to have potential for improving endurance performance. Similarly, the inclusion of caffeine in beverages consumed 60 minutes before prolonged exercise improves athletic performance for many subjects. Others may be hypersensitive to the effects of caffeine and are adversely affected by its use. For exercise leading to exhaustion in less than 30 minutes, neither caffeine nor carbohydrate ingestion is effective in minimising homeostatic perturbations or improving exercise performance.(ABSTRACT TRUNCATED AT 400 WORDS)     

Perceptual responses in the heat after brief intravenous versus oral rehydration

PURPOSE: The purpose of the study was to compare the effects of a brief period (20 min) of intravenous (IV) fluid rehydration and oral (ORAL) rehydration on ratings of perceived exertion (RPE), thirst, and thermal sensation (TS) during exercise in the heat. METHODS: After dehydration (-4% of body weight), eight nonacclimated highly trained cyclists (age = 24 +/- 1 yr; VO2 = 61.4 +/- 0.8 mL.kg.min-1) performed three experimental trials. Rehydration (randomized, cross-over design) included: 1) ORAL (0.45% NaCl) equal to 50% of prior dehydration; 2) IV (0.45% NaCl) equal to 50% of prior dehydration; and 3) a control (CON), no fluid trial. Subjects then cycled at 74% VO2peak until volitional exhaustion in a hot environment (37 degrees C). RESULTS: Central (C-), local (L-), and overall-RPE (O-RPE) were significantly higher in CON compared to ORAL and IV at minutes 5 and 15 of exercise. C-RPE responses at minute 5 of exercise were lower (P < 0.05) during ORAL compared with IV, and C-RPE and O-RPE responses at minute 15 were lower (P < 0.05) during ORAL compared with IV. TS responses during CON were higher (P < 0.05) than ORAL and IV at minute 5, and TS was higher (P < 0.05) during IV versus ORAL at minute 15. TS were significantly correlated with all RPE responses at minute 15 in all trials. Thirst ratings were lower (P < 0.05) during ORAL compared with CON and IV at minutes 0, 5, and 15. CONCLUSION: It was concluded that ORAL resulted in lower RPE, thirst, and TS compared with CON and IV during exercise in the heat.