Fluid Needs for Training, Competition, and Recovery in Track-and-Field Athletes.

The 2019 International Amateur Athletics Federation Track-and-Field World Championships will take place in Qatar in the Middle East. The 2020 Summer Olympics will take place in Tokyo, Japan. It is quite likely that these events may set the record for hottest competitions in the recorded history of both the Track-and-Field World Championships and Olympic Games. Given the extreme heat in which track-and-field athletes will need to train and compete for these games, the importance of hydration is amplified more than in previous years. The diverse nature of track-and-field events, training programs, and individuality of athletes taking part inevitably means that fluid needs will be highly variable. Track-and-field events can be classified as low, moderate, or high risk for dehydration based on typical training and competition scenarios, fluid availability, and anticipated sweat losses. This paper reviews the risks of dehydration and potential consequences to performance in track-and-field events. The authors also discuss strategies for mitigating the risk of dehydration.

IOC consensus statement: dietary supplements and the high-performance athlete.

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete's health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use.

Making Decisions About Supplement Use.

The use of dietary supplements is widespread among athletes in all sports and at all levels of competition, as it is in the general population. For the athlete training at the limits of what is sustainable, or for those seeking a shortcut to achieving their aims, supplements offer the prospect of bridging the gap between success and failure. Surveys show, however, that this is often not an informed choice and that the knowledge level among consumers is often low and that they are often influenced in their decisions by individuals with an equally inadequate understanding of the issues at stake. Supplement use may do more harm than good, unless it is based on a sound analysis of the evidence. Where a deficiency of an essential nutrient has been established by appropriate investigations, supplementation can provide a rapid and effective correction of the problem. Supplements can also provide a convenient and time-efficient solution to achieving the necessary intake of key nutrients such as protein and carbohydrate. Athletes contemplating the use of supplements should consider the potential for both positive and negative outcomes. Some ergogenic supplements may be of benefit to some athletes in some specific contexts, but many are less effective than is claimed. Some may be harmful to health of performance and some may contain agents prohibited by anti-doping regulations. Athletes should make informed choices that maximize the benefits while minimizing the risks.

IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete.

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

Effect of Exercise Intensity on Subsequent Gastric Emptying Rate in Humans.

Previous investigations have suggested that exercise at intensities greater than 70% maximal oxygen uptake (VO2max) 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.

Electrolyte supplementation during severe energy restriction increases exercise capacity in the heat.

PURPOSE: This study examined the effects of sodium chloride and potassium chloride supplementation during 48-h severe energy restriction on exercise capacity in the heat. METHODS: Nine males completed three 48-h trials: adequate energy intake (100 % requirement), adequate electrolyte intake (CON); restricted energy intake (33 % requirement), adequate electrolyte intake (ER-E); and restricted energy intake (33 % requirement), restricted electrolyte intake (ER-P). At 48 h, cycling exercise capacity at 60 % VO2 peak was determined in the heat (35.2 °C; 61.5 % relative humidity). RESULTS: Body mass loss during the 48 h was greater during ER-P [2.16 (0.36) kg] than ER-E [1.43 (0.47) kg; P < 0.01] and CON [0.39 (0.68) kg; P < 0.001], as well as greater during ER-E than CON (P < 0.01). Plasma volume decreased during ER-P (P < 0.001), but not ER-E or CON. Exercise capacity was greater during CON [73.6 (13.5) min] and ER-E [67.0 (17.2) min] than ER-P [56.5 (13.1) min; P < 0.01], but was not different between CON and ER-E (P = 0.237). Heart rate during exercise was lower during CON and ER-E than ER-P (P < 0.05). CONCLUSIONS: These results demonstrate that supplementation of sodium chloride and potassium chloride during energy restriction attenuated the reduction in exercise capacity that occurred with energy restriction alone. Supplementation maintained plasma volume at pre-trial levels and consequently prevented the increased heart rate observed with energy restriction alone. These results suggest that water and electrolyte imbalances associated with dietary energy and electrolyte restriction might contribute to reduced exercise capacity in the heat.

Effect of electrolyte addition to rehydration drinks consumed after severe fluid and energy restriction.

This study examined the effect of electrolyte addition to drinks ingested after severe fluid and energy restriction (FER). Twelve subjects (6 male and 6 female) completed 3 trials consisting of 24-hour FER (energy intake: 21 kJ·kg body mass; water intake: 5 ml·kg body mass), followed by a 2-hour rehydration period and a 4-hour monitoring period. During rehydration, subjects ingested a volume of drink equal to 125% of the body mass lost during FER in 6 aliquots, once every 20 minutes. Drinks were a sugar-free lemon squash (P) or the P drink with the addition of 50 mmol·L sodium chloride (Na) or 30 mmol·L potassium chloride (K). Total void urine samples were given before and after FER and every hour during rehydration and monitoring. Over all trials, FER produced a 2.1% reduction in body mass and negative sodium (-67 mmol), potassium (-48 mmol), and chloride (-84 mmol) balances. Urine output after drinking was 1627 (540) ml (P), 1391 (388) ml (K), and 1150 (438) ml (Na), with a greater postdrinking urine output during P than Na (p ≤ 0.05). Ingestion of drink Na resulted in a more positive sodium balance compared with P or K (p < 0.001), whereas ingestion of drink K resulted in a more positive potassium balance compared with P or Na (p < 0.001). These results demonstrate that after 24-hour FER, ingestion of a high sodium drink results in an increased sodium balance that augments greater drink retention compared with a low electrolyte placebo drink.

Voluntary water intake during and following moderate exercise in the cold.

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, VO2peak 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% VO2peak (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.

Beverage consumption habits "24/7" among British adults: association with total water intake and energy intake.

BACKGROUND: Various recommendations exist for total water intake (TWI), yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI). METHODS: We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19-64 years (2000/2001) to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values. RESULTS: Mean TWI was 2.53 L (SD 0.86) for men and 2.03 L (SD 0.71) for women, close to the European Food Safety Authority "adequate Intake" (AI) of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was <1 g/kcal. Beverages accounted for 75% of TWI. Beverage variety was correlated with TWI (r 0.34) and more weakly with EI (r 0.16). Beverage consumption peaked at 0800 hrs (mainly hot beverages/ milk) and 2100 hrs (mainly alcohol). Total beverage consumption was higher at weekends, especially among men. Overall, beverages supplied 16% of EI (men 17%, women 14%), alcoholic drinks contributed 9% (men) and 5% (women), milk 5-6%, caloric soft drinks 2%, and fruit juice 1%.In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting), replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol) with 100 g non-caloric drinks (diet soft drinks, hot beverages and water) was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean) each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was 47 kcal/100 g. CONCLUSIONS: TWI and beverage consumption are closely related, and some individuals appeared to have low TWI. Compensation for energy from beverages may occur but is partial. A better understanding of interactions between drinking and eating habits and their impact on water and energy balance would give a firmer basis to dietary recommendations.

The effects of high-intensity intermittent exercise compared with continuous exercise on voluntary water ingestion.

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. Thu.s, the aim was to assess voluntary water intake following HIIE. Ten healthy males (22 ± 2 y, 75.6 ± 6.9 kg, VO2(peak) 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% VO2(peak repeated for 60 min (HIIE) or 60 min continuously at 33% VO2(peak) (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 ± 4 mOsmol · 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.

Fluid and electrolyte balance during 24-hour fluid and/or energy restriction.

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.

The effects of repeated ingestion of high and low glucose-electrolyte solutions on gastric emptying and blood 2H2O concentration after an overnight fast.

The addition of carbohydrate to drinks designed to have a role in rehydrating the body is commonplace. The gastric emptying and fluid uptake characteristics following repeated ingestion of drinks with high and low glucose concentrations were examined in eight subjects (three male and five female). Following a 13 h fluid restriction period, the subjects ingested a volume of test solution amounting to 3 % of the initial body mass over a period of 60 min. Test drinks were 2 and 10 % glucose-electrolyte solutions with osmolalities of 189 (SD 3) and 654 (SD 3) mOsm/kg, respectively. The initial bolus of each test solution contained 10 g of (2)H(2)O. Blood samples were collected throughout drinking and for 60 min afterwards. Gastric volumes were determined via gastric aspiration at 15 min intervals for 120 min. No difference between trials in total stomach volume was observed until 30 min after the ingestion of the first bolus of test drink, but blood (2)H concentration was increased during both trials 10 min after ingestion of the first bolus. Blood (2)H concentration was greater at this time point during the 2 % glucose trial than during the 10 % glucose trial and remained higher for the duration of the trial with the exception of one time point. Urine volume at the end of the trial was greater in the 2 % glucose trial than in the 10 % glucose trial. It is concluded that the reduced overall rate of fluid uptake following ingestion of the 10 % glucose solution was due largely to a relatively slow rate of gastric emptying.

Fluid and electrolyte needs for training, competition, and recovery.

Fluids and electrolytes (sodium) are consumed by athletes, or recommended to athletes, for a number of reasons, before, during, and after exercise. These reasons are generally to sustain total body water, as deficits (hypohydration) will increase cardiovascular and thermal strain and degrade aerobic performance. Vigorous exercise and warm/hot weather induce sweat production, which contains both water and electrolytes. Daily water (4-10 L) and sodium (3500-7000 mg) losses in active athletes during hot weather exposure can induce water and electrolyte deficits. Both water and sodium need to be replaced to re-establish "normal" total body water (euhydration). This replacement can be by normal eating and drinking practices if there is no urgency for recovery. But if rapid recovery (<24 h) is desired or severe hypohydration (>5% body mass) is encountered, aggressive drinking of fluids and consuming electrolytes should be encouraged to facilitate recovery for subsequent competition.

Acute effects of ingesting glucose solutions on blood and plasma volume.

The change in blood and plasma volume following ingestion of glucose solutions of varying concentrations was estimated in twelve healthy male volunteers. Subjects consumed, within a 5 min period, 600 ml of a solution containing 0, 2, 5 or 10 % glucose with osmolalities of 0 (sd 0), 111 (sd 1), 266 (sd 7) and 565 (sd 5) mOsm/kg, respectively. Blood samples were collected over the course of 1 h after ingestion at intervals of 10 min. After ingestion of the 2 % glucose solution, plasma volume increased from baseline levels at 20 min. Plasma volume decreased from baseline levels at 10 and 60 min after ingestion of the 10 % glucose solution. Heart rate was elevated at 10 and 60 min after ingestion of the 10 % glucose solution and decreased at 30 and 40 min after ingestion of the 2 % glucose solution relative to the average heart rate recorded before drinking. It is concluded that ingestion of hypertonic, energy-dense glucose solutions results in a decrease in plasma and extracellular fluid volume, most likely due to the net secretion of water into the intestinal lumen.

Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining.

Muscle cramp is a temporary but intense and painful involuntary contraction of skeletal muscle that can occur in many different situations. The causes of, and cures for, the cramps that occur during or soon after exercise remain uncertain, although there is evidence that some cases may be associated with disturbances of water and salt balance, while others appear to involve sustained abnormal spinal reflex activity secondary to fatigue of the affected muscles. Evidence in favour of a role for dyshydration comes largely from medical records obtained in large industrial settings, although it is supported by one large-scale intervention trial and by field trials involving small numbers of athletes. Cramp is notoriously unpredictable, making laboratory studies difficult, but experimental models involving electrical stimulation or intense voluntary contractions of small muscles held in a shortened position can induce cramp in many, although not all, individuals. These studies show that dehydration has no effect on the stimulation frequency required to initiate cramping and confirm a role for spinal pathways, but their relevance to the spontaneous cramps that occur during exercise is questionable. There is a long history of folk remedies for treatment or prevention of cramps; some may reduce the likelihood of some forms of cramping and reduce its intensity and duration, but none are consistently effective. It seems likely that there are different types of cramp that are initiated by different mechanisms; if this is the case, the search for a single strategy for prevention or treatment is unlikely to succeed.

Effects of milk ingestion on prolonged exercise capacity in young, healthy men.

OBJECTIVE: The effects of fluid intake during prolonged exercise have been extensively studied but at present there exists little information on the effects of milk-based drinks on the response to prolonged exercise. Thus, the purpose of this study was to investigate the effects of milk-based drinks on exercise capacity. METHODS: Eight healthy males (age 24 +/- 4 y, height 1.76 +/- 0.04 m, mass 68.9 +/- 9.5 kg, body fat 12.5 +/- 2.4%, peak oxygen consumption 4.3 +/- 0.6 L/min) exercised to volitional exhaustion at 70% peak oxygen consumption on four occasions. Subjects ingested 1.5 mL/kg body mass of plain water, a carbohydrate-electrolyte solution, low-fat (0.1%) milk, or low-fat (0.1%) milk with added glucose before and every 10 min during exercise. The effect of the drink on exercise capacity and the cardiovascular, metabolic, and thermoregulatory responses to prolonged exercise were examined. RESULTS: Exercise time to exhaustion was not significantly influenced by the drink ingested (P = 0.19), but there was a tendency for subjects to exercise longer when the carbohydrate-electrolyte (110.6, range 82.0-222.7 min), milk (103.3, range 85.7-228.5 min), or milk plus glucose (102.8, range 74.3-167.1 min) was ingested compared with water (93.3, range 82.4-192.3 min). The solution ingested did not influence the cardiovascular, metabolic, or thermoregulatory response to exercise. CONCLUSION: The results of this study suggest that although the low-fat milk-based fluids did not enhance exercise capacity over that seen with the ingestion of plain water, the effect was comparable to that observed with a carbohydrate-electrolyte beverage.

Heat and cold : what does the environment do to the marathon runner?

The marathon poses a considerable physical challenge for athletes of all levels. When combined with high heat and humidity, not only is performance potentially compromised, but health and well-being are also at risk. There are well recognised effects of heat and hydration status on the cardiovascular and thermoregulatory systems that can account for the decreased performance and increased sensation of effort that are experienced when competing in the heat. Elevated exercise heart rate and core temperature at the same absolute exercise intensity are commonly reported. Dehydration occurring during exercise in the heat and results in reductions in stroke volume, cardiac output and blood pressure, as well as a marked decline in blood flow to the working muscles. Recent work suggests that hyperthermia may have a direct affect on the CNS and the brain may contribute to fatigue during prolonged exercise in a warm environment. At present, evidence supports a significant role of catecholaminergic neurotransmission, but there are a number of metabolic and circulatory perturbations occurring within the brain that may also be important in the fatigue process.

Nutrition and hydration concerns of the female football player.

There is little information on the nutritional habits of female football players at any level of the game. There is also a shortage of information on the nutrition and hydration strategies that players should adopt. In general, differences in nutritional needs between males and females are smaller than differences between individuals, so that principles developed for male players also apply to women. There is a need to address energy balance and body composition: prolonged energy deficits cannot be sustained without harm to health and performance. Published reports show mean carbohydrate intakes for female players of about 5 g/kg/day, and this seems to be too low to sustain consistent intensive training. The timing of protein intake may be as important as the amounts consumed, provided that the total intake is adequate. Dehydration adversely affects skill and stamina in women as it does in men, so an individualised hydration strategy should be developed. The prevalence of iron deficiency in women generally is high, but it seems to be alarmingly high in female players. All players should adopt dietary habits that ensure adequate iron intake. Football training seems to increase bone mass in the weight-bearing limbs, with positive implications for bone health in later life, but some players may be at risk from inadequate calcium dietary intake.

Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration.

Hypohydration, or a body water deficit, is a common occurrence in athletes and recreational exercisers following the completion of an exercise session. For those who will undertake a further exercise session that day, it is important to replace water losses to avoid beginning the next exercise session hypohydrated and the potential detrimental effects on performance that this may lead to. The aim of this review is to provide an overview of the research related to factors that may affect postexercise rehydration. Research in this area has focused on the volume of fluid to be ingested, the rate of fluid ingestion, and fluid composition. Volume replacement during recovery should exceed that lost during exercise to allow for ongoing water loss; however, ingestion of large volumes of plain water results in a prompt diuresis, effectively preventing longer-term maintenance of water balance. Addition of sodium to a rehydration solution is beneficial for maintenance of fluid balance due to its effect on extracellular fluid osmolality and volume. The addition of macronutrients such as carbohydrate and protein can promote maintenance of hydration by influencing absorption and distribution of ingested water, which in turn effects extracellular fluid osmolality and volume. Alcohol is commonly consumed in the postexercise period and may influence postexercise rehydration, as will the coingestion of food. Future research in this area should focus on providing information related to optimal rates of fluid ingestion, advisable solutions to ingest during different duration recovery periods, and confirmation of mechanistic explanations for the observations outlined.