Low daily water intake profile-is it a contributor to disease?

Few previous review articles have focused on the associations between inadequate daily water intake (LOW) or urinary biomarkers of dehydration (UD; low urine volume or high urine osmolality) and multiple diseases. Accordingly, we conducted manual online searches (47 key words) of the PubMed, Embase, and Google Scholar databases with these inclusion criteria: English language, full-text, peer reviewed, no restriction on research design, and three publications minimum. Initially, 3,903 articles were identified based on their titles and abstracts. Evaluations of full length .pdf versions identified 96 studies that were acceptable for inclusion. We concluded that the evidence is insufficient or conflicting for seven disorders or diseases (i.e. suggesting the need for additional clarifying research) and it is lacking for all-cause mortality. Differential characterizations among women and men have been reported in the results of nine studies involving five diseases. Finally, the evidence for associations of LOW or UD is strong for both kidney stones and type 2 diabetes with hyperglycemia. This suggests that great public health value (i.e. reduced disease risk) may result from increased daily water intake-a simple and cost-effective dietary modification.

Characterizing Hydration Practices in Healthy Young Recreationally Active Adults-Is There Utility in First Morning Urine Sampling?

First morning urine (FMU) assessment would be a practical and convenient solution for clinically acceptable detection of underhydration prior to competition/training, and for the general public. Thus, we thus sought to determine the diagnostic accuracy of FMU as a valid indicator of recent (previous 24 hr, 5 days average) hydration practices. For 5 consecutive days and one final morning, 67 healthy women (n = 38) and men (n = 29; age: 20 [1] years, body mass index: 25.9 [5.5]) completed 24-hr diet logs for total water intake (from beverages and foods, absolute and relative to body mass), 24-hr urine and FMU collection (last morning only) for osmolality (Osm), specific gravity (SG), and color (Col), and morning blood sampling for plasma osmolality and copeptin. Correlations determined significance and relationship strength among FMU and all other variables. Area under the receiver operating characteristic curves, sensitivity, specificity, and positive likelihood ratios were employed using previously reported values to indicate underhydration (total water intake < 30 ml/kg, osmolality > 500, and >800 mOsm/kg, specific gravity > 1.017, and copeptin > 6.93 pmol/L). FMU_Osm and FMU_SG were significantly correlated (p < .05) to all variables except the previous 5-day plasma osmolality. FMU_Col was only significantly correlated with other color time intervals and total water intake per gram. FMU_Osm held greatest utility (area under the receiver operating characteristic curve, sensitivity, and specificity >80%) overall, with the best outcome being FMU_Osm indicating a previous 24-hr osmolality threshold of 500 mOsm/kg (FMU_Osm criterion >710 mOsm/kg and positive likelihood ratio = 5.9). With less effort and cost restriction, FMU is a viable metric to assess underhydration.

Hydration Biomarkers Are Related to the Differential Abundance of Fecal Microbiota and Plasma Lipopolysaccharide-Binding Protein in Adults.

INTRODUCTION: Prevalence of chronic hypohydration remains elevated among adults in the USA; however, the health effects of hypohydration in regards to human gut health have not been explored. METHODS: This study examined the relationship between total water intake, hydration biomarkers (first-morning urine specific gravity [FMUsg], first-morning urine volume [FMUvol], and plasma copeptin), fecal microbiota, and plasma lipopolysaccharide-binding protein (LBP) in adults (25-45 years, 64% female). Fecal microbiota composition was assessed using 16S rRNA gene sequencing (V4 region). Immunoassays quantified plasma copeptin and LBP in fasted venous blood samples. Dietary variables were measured using 7-day food records. Linear discriminant analysis effect size (LEfSe) analyzed differentially abundant microbiota based on median cutoffs for hydration markers. Multiple linear regressions examined the relationship between LBP and copeptin. RESULTS: LEfSe identified 6 common taxa at the genus or species level that were differentially abundant in FMUsg, total water (g/day), or plasma copeptin (µg/mL) groups when split by their median values. Uncultured species in the Bacteroides, Desulfovibrio, Roseburia, Peptococcus, and Akkermansia genera were more abundant in groups that might indicate poorer hydration status. Multivariate linear analyses revealed a positive relationship between plasma copeptin and LBP when controlling confounding variables (F(6,52) = 4.45, p = 0.002, R2 = 0.34). CONCLUSIONS: Taxa common between markers are associated with the intestinal mucus layer, which suggests a potential link between hydration status and intestinal mucus homeostasis. The relationship between LBP and copeptin indicates that copeptin may be sensitive to metabolic endotoxemia and potentially gut barrier function.

Models of hydration and nutrition require environmental data.

OBJECTIVE: To recognize the causality of environmental factors (i.e. temperature, humidity and sun exposure) on nutritional variables, specifically body water balance and water-seeking behaviour. DESIGN: Author perspective. SETTING: Global. PARTICIPANTS: Not applicable. RESULTS: A free-standing code supplement is provided to facilitate investigators in accessing meteorological data for incorporation into analyses related to nutrition and hydration. CONCLUSIONS: Analytical models related to human hydration should account for the environment de rigueur.

Urine color as an indicator of urine concentration in pregnant and lactating women.

AIM: Urine concentration measured via osmolality (U OSM) and specific gravity (U SG) reflects the adequacy of daily fluid intake, which has important relationships to health in pregnant (PREG) and lactating (LACT) women. Urine color (U COL) may be a practical, surrogate marker for whole-body hydration status. PURPOSE: To determine whether U COL was a valid measure of urine concentration in PREG and LACT, and pair-matched non-pregnant, non-lactating control women (CON). METHODS: Eighteen PREG/LACT (age 31 ± 1 years, pre-pregnancy BMI 24.3 ± 5.9 kg m-2) and eighteen CON (age 29 ± 4 years, BMI 24.1 ± 3.7 kg m-2) collected 24-h and single-urine samples on specified daily voids at five time points (15 ± 2, 26 ± 1, and 37 ± 1 weeks gestation, 3 ± 1 and 9 ± 1 weeks postpartum during lactation; CON visits were separated by similar time intervals) for measurement of 24-h U OSM, U SG, and U COL and single-sample U OSM and U COL. RESULTS: Twenty-four-hour U COL was significantly correlated with 24-h U OSM (r = 0.6085-0.8390, P < 0.0001) and 24-h U SG (r = 0.6213-0.8985, P < 0.0001) in all groups. A 24-h U COL ≥ 4 (AUC = 0.6848-0.9513, P < 0.05) and single-sample U COL ≥ 4 (AUC = 0.9094-0.9216, P < 0.0001) indicated 24-h U OSM ≥ 500 mOsm kg-1 (representing inadequate fluid intake) in PREG, LACT, and CON. CONCLUSIONS: Urine color was a valid marker of urine concentration in all groups. Thus, PREG, LACT, and CON can utilize U COL to monitor their daily fluid balance. Women who present with a U COL ≥ 4 likely have a U OSM ≥ 500 mOsm kg-1 and should increase fluid consumption to improve overall hydration status.

Effect of Caffeine on Perceived Soreness and Functionality Following an Endurance Cycling Event.

Caldwell, AR, Tucker, MA, Butts, CL, McDermott, BP, Vingren, JL, Kunces, LJ, Lee, EC, Munoz, CX, Williamson, KH, Armstrong, LE, and Ganio, MS. Effect of caffeine on perceived soreness and functionality following an endurance cycling event. J Strength Cond Res 31(3): 638-643, 2017-Caffeine can reduce muscle pain during exercise; however, the efficacy of caffeine in improving muscle soreness and recovery from a demanding long-duration exercise bout has not been established. The purpose of this study was to investigate the effects of caffeine intake on ratings of perceived muscle soreness (RPMS) and perceived lower extremity functionality (LEF) following the completion of a 164-km endurance cycling event. Before and after cycling RPMS (1-to-6; 6 = severe soreness) and LEF (0-to-80; 80 = full functionality) were assessed by questionnaires. Subjects ingested 3 mg/kg body mass of caffeine or placebo pills in a randomized, double-blind fashion immediately after the ride and for the next 4 mornings (i.e., ∼800 hours) and 3 afternoons (i.e., ∼1200 hours). Before each ingestion, RPMS and LEF were assessed. Afternoon ratings of LEF were greater with caffeine ingestion the first day postride (65.0 ± 6.1 vs. 72.3 ± 6.7; for placebo and caffeine, respectively; p = 0.04), but at no other time points (p > 0.05). The caffeine group tended to have lower overall RPMS in the afternoon versus placebo (i.e., main effect of group; 1.1 ± 0.2 vs. 0.5 ± 0.2; p = 0.09). Afternoon RPMS for the legs was significantly lower in the caffeine group (main effect of caffeine; 1.3 ± 0.2 vs. 0.5 ± 0.3; p = 0.05). In conclusion, ingesting caffeine improved RPMS for the legs, but not LEF in the days following an endurance cycling event. Athletes may benefit from ingesting caffeine in the days following an arduous exercise bout to relieve feelings of soreness and reduced functionality.

Effects of Three Oral Nutritional Supplements on Human Hydration Indices.

Urine color (Ucol) as a hydration assessment tool provides practicality, ease of use, and correlates moderately to strongly with urine specific gravity (Usg) and urine osmolality (Uosm). Indicative of daily fluid turnover, along with solute and urochrome excretion in 24-hr samples, Ucol may also reflect dietary composition. Thus, the purpose of this investigation was to determine the efficacy of Ucol as a hydration status biomarker after nutritional supplementation with beetroot (880 mg), vitamin C (1000 mg), and riboflavin (200 mg). Twenty males (Mean ± SD; age, 21 ± 2 y; body mass, 82.12 ± 15.58 kg; height, 1.77 ± 0.06 m) consumed a standardized breakfast and collected all urine voids on one control day (CON) and 1 day after consuming a standardized breakfast and a randomized and double-blinded supplement (SUP) over 3 weeks. Participants replicated exercise and diet for one day before CON, and throughout CON and SUP. Ucol, Usg, Uosm, and urine volume were measured in all 24-hr samples, and Ucol and Usg were measured in all single samples. Ucol was a significant predictor of single sample Usg after all supplements (p < .05). Interestingly, 24-hr Ucol was not a significant predictor of 24-h Usg and Uosm after riboflavin supplementation (p = .20, p = .21). Further, there was a significant difference between CON and SUP 24-h Ucol only after riboflavin supplementation (p < .05). In conclusion, this investigation suggests that users of the UCC (urine color chart) should consider riboflavin supplementation when classifying hydration status and use a combination of urinary biomarkers (e.g., Usg and Ucol), both acutely and over 24 hr.

Observed Dietary Practices of Recreational Ultraendurance Cyclists in the Heat.

Dietary approaches for optimizing exercise performance have been debated in the literature for years. For endurance athletes, various position stands focus on recommendations for high-carbohydrate diets to maximize performance in events. However, theories of low-carbohydrate diets and their ability to provide more fuel may prove beneficial to ultraendurance athletes. Therefore, the purpose of this research was to observe the food and fluid consumption of successful recreational ultraendurance cyclists on the day before (ED-1), Event Day, and the day after (ED+1), a 162 km endurance event in a hot environment, and subsequently compare dietary intakes to recommendations and other observed dietary practices. Twenty men (age, 48 ± 8 years; mass, 85.1 ± 13.4 kg; height, 178.2 ± 7.4 cm) recorded all dietary items during ED-1, Event Day, and ED+1. Diet composition and the relationships between carbohydrate and caloric intake with finish time were examined. Results show athletes consumed a high-carbohydrate diet on ED-1 (384 g·d), Event Day (657 g·d), and ED+1 (329 g·d). However, there were no significant associations between carbohydrate (p > 0.05), or caloric intake (p > 0.05), and finish time. This study results great variation in diets of recreational endurance cyclists, although most consume within nationally recognized dietary recommendation ranges. Because there is great variation and lack of correlation with performance, these findings suggest that current high-carbohydrate dietary recommendations for general endurance athletes may not be sport specific or individualized enough for recreational ultraendurance cyclists, and that individualized dietary macronutrient composition manipulations may improve performance outcomes.

Markers of the hydration process during fluid volume modification in women with habitual high or low daily fluid intakes.

PURPOSE: Human daily total water intake (TWI) has a large inter-individual range. Recently, water supplementation has been suggested as a potential preventative and therapeutic modality. Thus, we aimed to measure hydration biomarkers in women with high (HIGH) versus low (LOW) daily TWI to determine baseline differences, and the efficacy of these markers during a systematic alteration in TWI. METHODS: This cohort study identified 14 HIGH [3.34 (0.56) L day(-1)] and 14 LOW [1.62 (0.48) L day(-1)] from 120 women. Next, fluid intake was decreased in HIGH [2.00 (0.21) L day(-1)] while LOW increased [3.50 (0.13) L day(-1)] across 4 days. Body mass, fluid intake, serum osmolality (S osmo), total plasma protein (TPP), 24 h urine osmolality, and 24 h urine volume, were measured on each day of modified TWI. Estimated plasma volume (E pv) was calculated using measured body mass and hematocrit values. RESULTS: At baseline, urinary markers and TPP differentiated HIGH from LOW [7.0 (0.3) versus 7.3 (0.3) mg dL(-1), respectively]. Upon TWI intervention, (1) body mass decreased in HIGH [-0.7 (1.1) kg, p = 0.010)] but did not increase in LOW [+0.0 (0.6) kg, p = 0.110], (2) E pv decreased 2.1 (2.4) %, p = 0.004, (3) urine osmolality increased in HIGH [397 (144)-605 (230) mOsm kg(-1), p < 0.001] and decreased in LOW [726 (248)-265 (97) mOsm kg(-1) p < 0.001], and (4) no changes of serum osmolality occurred in either HIGH or LOW (all p > 0.05). CONCLUSIONS: Urinary markers and TPP are sensitive measures to habitual high and low TWI and to changes in TWI. Both groups through urinary and some hematological responses following TWI manipulation achieved regulation of hemoconcentration.

Habitual total water intake and dimensions of mood in healthy young women.

Acute negative and positive mood states have been linked with the development of undesirable and desirable health outcomes, respectively. Numerous factors acutely influence mood state, including exercise, caffeine ingestion, and macronutrient intake, but the influence of habitual total water intake remains unknown. The purpose of this study was to observe relationships between habitual water intake and mood. One hundred twenty healthy females (mean ± SD; age = 20 ± 2 y, BMI = 22.9 ± 3.5 kg⋅m(-2) ) recorded all food and fluids consumed for 5 consecutive days. Investigators utilized dietary analysis software to determine Total Water Intake (TWI; total water content in foods and fluids), caffeine, and macronutrient consumption (i.e. protein, carbohydrate, fat). On days 3 and 4, participants completed the Profile of Mood State (POMS) questionnaire, which examined tension, depression, anger, vigor, and confusion, plus an aggregate measure of Total Mood Disturbance (TMD). For comparison of mood, data were separated into three even groups (n = 40 each) based on TWI: low (LOW; 1.51 ± 0.27 L/d), moderate (MOD; 2.25 ± 0.19 L/d), and high (HIGH; 3.13 ± 0.54 L/d). Regression analysis was performed to determine continuous relationships between measured variables. Group differences (p < 0.05) were observed for tension (MOD = 7.2 ± 5.4, HIGH = 4.4 ± 2.9), depression (LOW = 4.5 ± 5.9, HIGH = 1.7 ± 2.3), confusion (MOD = 5.9 ± 3.4, HIGH = 4.0 ± 2.1), and TMD (LOW=19.0 ± 21.8, HIGH=8.2 ± 14.2). After accounting for other mood influencers, TWI predicted TMD (r(2) = 0.104; p = 0.050). The above relationships suggest the amount of water a woman consumes is associated with mood state.

Effective body water and body mass changes during summer ultra-endurance road cycling.

Because body mass change (ΔMb) does not represent all water losses and gains, the present field investigation determined if (a) ΔMb equalled the net effective body water change during ultra-endurance exercise and (b) ground speed and exercise duration influenced these variables. Thirty-two male cyclists (age range, 35-52 years) completed a 164-km event in a hot environment, were retrospectively triplet matched and placed into one of three groups based on exercise duration (4.8, 6.3, 9.6 h). Net effective body water loss was computed from measurements (body mass, total fluid intake and urine excreted) and calculations (water evolved and mass loss due to substrate oxidation, solid food mass and sweat loss), including (ΔEBWgly) and excluding (ΔEBW) water bound to glycogen. With all cyclists combined, the mean ΔMb (i.e. loss) was greater than that of ΔEBWgly by 1200 ± 200 g (P = 1.4 × 10(-18)), was similar to ΔEBW (difference, 0 ± 200 g; P = .21) and was strongly correlated with both (R(2) = .98). Analysis of equivalence indicated that ΔMb was not equivalent to ΔEBWgly, but was equivalent to ΔEBW. Due to measurement complexity, we concluded that (a) athletes will not calculate the effective body water calculations routinely and (b) body mass change remains a useful field-expedient estimate of net effective body water change.

Hydration status affects mood state and pain sensation during ultra-endurance cycling.

Laboratory-based studies indicate mild dehydration adversely affects mood. Although ultra-endurance events often result in mild to moderate dehydration, little research has evaluated whether the relationship between hydration status and mood state also exists in these arduous events. Therefore, the purpose of this study was to evaluate how hydration status affected mood state and perceptual measures during a 161 km ultra-endurance cycling event. One hundred and nineteen cyclists (103 males, 16 females; age = 46 ± 9 years; height = 175.4 ± 17.9 cm; mass = 82.8 ± 16.3 kg) from the 2011 and 2013 Hotter'N Hell events participated. Perceived exertion, Thermal, Thirst, and Pain sensations, Brunel Profile of Mood States, and urine specific gravity (USG) were measured pre- (~1 h before), mid- (~97 km), and post-ride. Participants were classified at each time point as dehydrated (USG ≥ 1.022) or euhydrated (USG ≤ 1.018). Independent of time point, dehydrated participants (USG = 1.027 ± 0.004) had decreased Vigour and increased Fatigue, Pain, Thirst, and Thermal sensations compared to euhydrated participants (USG = 1.012 ± 0.004; all P < 0.01). USG significantly correlated with Fatigue (r = 0.36), Vigour (r = -0.27), Thirst (r = 0.15), and Pain (r = 0.22; all P < 0.05). In conclusion, dehydrated participants had greater Fatigue and Pain than euhydrated participants. These findings indicate dehydration may adversely affect mood state and perceptual ratings during ultra-endurance cycling.

Repetitive box lifting performance is impaired in a hot environment: implications for altered work-rest cycles.

This study investigated the effects of environmental temperature on repetitive box lifting (RBL) performance, associated stress hormone and creatine kinase (CK) responses. Ten healthy males performed two experimental trials in a random crossover design. The trials consisted of three 40 min (10 min sitting, 20 min standing, and 10 min RBL) circuits performed in either 23 °C or 38 °C followed by a 180 min seated recovery period in 23 °C. RBL performance (i.e., number of boxes lifted) was reduced (p ≤ 0.05) in 38 °C compared to the 23 °C trial. Physiological Strain Index was significantly different between trials (38 °C: 8.5 ± 1.1 versus 23 °C: 7.2 ± 0.7; p ≤ 0.01). Plasma testosterone was elevated (p ≤ 0.05) across both trials and then decreased at 60 min recovery, compared to pre-exercise (PRE) measures, but was higher (p ≤ 0.05) during the 38 °C trial. Plasma cortisol increased (p ≤ 0.05) at 60 min during both trials and remained elevated until 120 min in 23 °C, and until 60 min recovery in 38 °C. Serum CK was greater through 48 hr post compared to PRE values in both trials. Thus, 10 min RBL performance was reduced in 38 °C despite the 30-min rest periods between RBL intervals. Plasma testosterone and cortisol were generally higher during the 38 °C trial, suggesting a greater stress response. Additional research is needed to determine optimal work:rest cycles for maximizing work performance in thermally oppressive environments.

Effects of theobromine and caffeine on mood and vigilance.

Like caffeine, theobromine crosses the blood-brain barrier and binds to adenosine receptors, suggesting it might share caffeine's beneficial effects on mood and vigilance. Therefore, the purpose of this study was to assess the effect of theobromine doses commonly found in foods on mood and vigilance parameters sensitive to caffeine. Caffeine was tested as a positive control. Twenty-four men (age, 23 [3] years) completed 6 double-blind trials during which they consumed experimental beverages, assessed their mood using standardized self-report questionnaires, and completed a 2-hour visual vigilance task. Three experimental doses (100, 200, and 400 mg theobromine) were delivered in a cocoa-based beverage; 3 matched control treatments (0 mg theobromine, 400 mg theobromine, and 100 mg caffeine) were delivered in a non-cocoa beverage. Mean salivary concentrations of theobromine exhibited significant dose-dependent differences (400 mg trials > 200 mg trial > 100 mg trial > 0 mg trials; P < 0.005). At every dose tested, theobromine failed to consistently affect mood state or vigilance (P > 0.05), but 100-mg caffeine significantly decreased lethargy/fatigue and increased vigor (P = 0.006 and 0.011, respectively). These findings indicate theobromine does not influence mood and vigilance when administered in nutritionally relevant doses, despite sharing many of caffeine's structural characteristics.

Effect of different rest intervals after whole-body vibration on vertical jump performance.

Whole-body vibration (WBV) may potentiate vertical jump (VJ) performance via augmented muscular strength and motor function. The purpose of this study was to evaluate the effect of different rest intervals after WBV on VJ performance. Thirty recreationally trained subjects (15 men and 15 women) volunteered to participate in 4 testing visits separated by 24 hours. Visit 1 acted as a familiarization visit where subjects were introduced to the VJ and WBV protocols. Visits 2-4 contained 2 randomized conditions per visit with a 10-minute rest period between conditions. The WBV was administered on a pivotal platform with a frequency of 30 Hz and an amplitude of 6.5 mm in 4 bouts of 30 seconds for a total of 2 minutes with 30 seconds of rest between bouts. During WBV, subjects performed a quarter squat every 5 seconds, simulating a countermovement jump (CMJ). Whole-body vibration was followed by 3 CMJs with 5 different rest intervals: immediate, 30 seconds, 1 minute, 2 minutes, or 4 minutes. For a control condition, subjects performed squats with no WBV. There were no significant (p > 0.05) differences in peak velocity or relative ground reaction force after WBV rest intervals. However, results of VJ height revealed that maximum values, regardless of rest interval (56.93 ± 13.98 cm), were significantly (p < 0.05) greater than the control condition (54.44 ± 13.74 cm). Therefore, subjects' VJ height potentiated at different times after WBV suggesting strong individual differences in optimal rest interval. Coaches may use WBV to enhance acute VJ performance but should first identify each individual's optimal rest time to maximize the potentiating effects.

Validity of field expedient devices to assess core temperature during exercise in the cold.

INTRODUCTION: Exposure to cold environments affects human performance and physiological function. Major medical organizations recommend rectal temperature (TREC) to evaluate core body temperature (TcORE) during exercise in the cold; however, other field expedient devices claim to measure TCORE. The purpose of this study was to determine if field expedient devices provide valid measures of TcRE during rest and exercise in the cold. METHODS: Participants included 13 men and 12 women (age = 24 +/- 3 yr, height = 170.7 +/- 10.6 cm, mass = 73.4 +/- 16.7 kg, body fat = 18 +/- 7%) who reported being healthy and at least recreationally active. During 150 min of cold exposure, subjects sequentially rested for 30 min, cycled for 90 min (heart rate = 120-140 bpm), and rested for an additional 30 min. Investigators compared aural (T(AUR)), expensive axillary (T(AXLe)), inexpensive axillary (T(AXLi)), forehead (T(FOR)), gastrointestinal (T(GI)), expensive oral (T(ORLe)), inexpensive oral (T(ORLi)), and temporal (T(TEM)) temperatures to T(REc) every 15 min. Researchers used mean difference between each device and T(REC) (i.e., mean bias) as the primary criterion for validity. RESULTS: T(AUR), T(AXLe), T(AXLi), T(FOR), TORLe, T(ORLi), and TTEM provided significantly lower measures compared to T(REC) and fell below our validity criterion. T(GI) significantly exceeded T(REC) at three of eleven time points, but no significant difference existed between mean T(REC) and T(GI) across time. Only T(GI) achieved our validity criterion and compared favorably to T(REC). CONCLUSION: T(GI) offers a valid measurement with which to assess T(CORE) during rest and exercise in the cold; athletic trainers, mountain rescuers, and military medical personnel should avoid other field expedient devices in similar conditions.

Progression of human subjective perceptions during euhydration, mild dehydration, and drinking.

Thirst motivates consumption of water necessary for optimal health and cognitive-physiological functions. Other than thirst, little is known about coexisting perceptions and moods that provide information to the brain and participate in body water homeostasis. The purpose of this investigation was to observe perceptions, somatic sensations, and moods during controlled changes of hydration status. During routine daily activities interspersed with laboratory visits, 18 healthy young men (age, 23±3 y; body mass, 80.13±10.61 kg) self-reported hourly ratings (visual analog scales, VAS) of 17 subjective perceptions, across two 24-h periods (ad libitum food and water intake while euhydrated; water restriction with dry food intake [WR]) and during a 30-min rehydration session (R30, 1.46±0.47 L water intake). At the end of WR, body mass loss reached 1.67 kg (2.12%). Distinct perceptions were identified during euhydration, WR and immediately after R30. Starting approximately 4 h after WR began (body mass loss of ∼0.5%), perceptual changes included progressively intensifying ratings of thirst, mouth dryness, desire for water, and pleasantness of drinking. In comparison, immediately after R30, participants reported a reversal of the perceptions observed during WR (above) plus cooler thermal sensation, increased satisfaction, and stomach fullness. These VAS ratings suggested that aversive moods contributed to drinking behavior and supported previously published animal studies. In conclusion, this investigation delineates previously unreported perceptions and their evolution (e.g., appearance, extinction, time course) that motivated drinking during WR and discouraged overdrinking after R30.

Effects of cold water immersion on circulating inflammatory markers at the Kona Ironman World Championship.

Cold water immersion (CWI) purportedly reduces inflammation and improves muscle recovery after exercise, yet its effectiveness in specific contexts (ultraendurance) remains unclear. Thus, our aim was to study hematological profiles, systemic inflammation, and muscle damage responses to a specific post-race CWI (vs. control) during recovery after the Ironman World Championship, a culmination of ∼100 000 athletes competing in global qualifying Ironman events each year. Twenty-nine competitors were randomized into either a CWI or control (CON) group. Physiological parameters and blood samples were taken at pre-race, after intervention (POST), and 24 (+1DAY) and 48 hours (+2DAY) following the race. Muscle damage markers (plasma myoglobin, serum creatine kinase) were elevated at POST, +1DAY, and +2DAY, while inflammatory cytokines interleukin (IL)-6, IL-8, and IL-10 and total leukocyte counts were increased only at POST. CWI had no effect on these markers. Numbers of the most abundant circulating cell type, neutrophils, were elevated at POST more so in CWI (p < 0.05, vs. CON). Despite that neutrophil counts may be a sensitive marker to detect subtle effects, CWI does not affect recovery markers 24- and 48-hours post-race (vs. CON). Overall, we determined that our short CWI protocol was not sufficient to improve recovery. Novelty: Ironman World Championship event increased circulating muscle damage markers, inflammatory markers, and hematological parameters, including circulating immune cell sub-populations that recover 24-48 hours after the race. 12-min CWI post-ultraendurance event affects the absolute numbers of neutrophils acutely, post-race (vs. CON), but does not impact recovery 24- and 48-hours post-race.

Distinguishing Low and High Water Consumers-A Paradigm of Disease Risk.

A long-standing body of clinical observations associates low 24-h total water intake (TWI = water + beverages + food moisture) with acute renal disorders such as kidney stones and urinary tract infections. These findings prompted observational studies and experimental interventions comparing habitual low volume (LOW) and high volume (HIGH) drinkers. Investigators have learned that the TWI of LOW and HIGH differ by 1-2 L·d-1, their hematological values (e.g., plasma osmolality, plasma sodium) are similar and lie within the laboratory reference ranges of healthy adults and both groups appear to successfully maintain water-electrolyte homeostasis. However, LOW differs from HIGH in urinary biomarkers (e.g., reduced urine volume and increased osmolality or specific gravity), as well as higher plasma concentrations of arginine vasopressin (AVP) and cortisol. Further, evidence suggests that both a low daily TWI and/or elevated plasma AVP influence the development and progression of metabolic syndrome, diabetes, obesity, chronic kidney disease, hypertension and cardiovascular disease. Based on these studies, we propose a theory of increased disease risk in LOW that involves chronic release of fluid-electrolyte (i.e., AVP) and stress (i.e., cortisol) hormones. This narrative review describes small but important differences between LOW and HIGH, advises future investigations and provides practical dietary recommendations for LOW that are intended to decrease their risk of chronic diseases.

Diagnostic accuracy of urinary indices to detect mild dehydration in young men following acute riboflavin, Vitamin C or beetroot supplementation.

BACKGROUND: Individuals of all ages are encouraged to monitor their hydration status daily to prevent clinically severe fluid imbalances such as hyponatremia or dehydration. However, acute oral nutritional supplementation may alter urinary hydration assessments and potentially increase the likelihood of inappropriate clinical decisions or diagnosis. This investigation sought to examine the influence of three common over-the-counter nutritional supplements (beetroot, riboflavin, and Vitamin C) on urinary hydration assessments in physically active young men after a 2% exercise-induced dehydration. DESIGN: Eight males (Mean ± SD; age: 22 ± 3 yr; body mass index: 27 ± 5.0) consumed either a standard meal with supplementation (intervention) or a standard meal without supplementation (control). Participants performed a variety of aerobic or resistance exercises until reaching ≥2% body mass loss in a counter-balanced, double-blinded design. Following exercise participation, urine samples were collected for an 8 h observational period during which food consumption was replicated. Urine samples were analyzed for urine color, specific gravity, volume, and osmolality. Maintenance of ~2% body mass loss (2.6 ± 0.5%; range: 1.7-4.0%) was confirmed following the 8 h observational period. RESULTS: Statistically significant (p < 0.05) changes were noted in urine color following Vitamin C supplementation compared to control; however, the difference was not clinically meaningful. CONCLUSIONS: These findings indicate that urine color, specific gravity, and osmolality maintain clinical utility to detect moderate levels of dehydration in physically active men consuming commercially available doses of beetroot, riboflavin, or Vitamin C.