H2OAthletes study protocol: effects of hydration changes on neuromuscular function in athletes.

We aim to understand the effects of hydration changes on athletes' neuromuscular performance, on body water compartments, fat-free mass hydration and hydration biomarkers and to test the effects of the intervention on the response of acute dehydration in the hydration indexes. The H2OAthletes study (clinicaltrials.gov ID: NCT05380089) is a randomised controlled trial in thirty-eight national/international athletes of both sexes with low total water intake (WI) (i.e. < 35·0 ml/kg/d). In the intervention, participants will be randomly assigned to the control (CG, n 19) or experimental group (EG, n 19). During the 4-day intervention, WI will be maintained in the CG and increased in the EG (i.e. > 45·0 ml/kg/d). Exercise-induced dehydration protocols with thermal stress will be performed before and after the intervention. Neuromuscular performance (knee extension/flexion with electromyography and handgrip), hydration indexes (serum, urine and saliva osmolality), body water compartments and water flux (dilution techniques, body composition (four-compartment model) and biochemical parameters (vasopressin and Na) will be evaluated. This trial will provide novel evidence about the effects of hydration changes on neuromuscular function and hydration status in athletes with low WI, providing useful information for athletes and sports-related professionals aiming to improve athletic performance.

Athletes with different habitual fluid intakes differ in hydration status but not in body water compartments.

Physiological differences have been reported between individuals who have habitual low (LOW) and high (HIGH) water intake (WI). The aims of this study were to explore body water compartments, hydration status, and fat-free mass (FFM) hydration of elite athletes exposed to different habitual WI. A total of 68 athletes (20.6 ± 5.3 years, 23 females) participated in this observational cross-sectional study. Total WI was assessed by seven-day food diaries and through WI, athletes were categorized as HIGH (n = 28, WI≥40.0 mL/kg/d) and LOW (n = 40, WI≤35.0 mL/kg/d). Total body water (TBW) and extracellular water (ECW) were determined by dilution techniques and intracellular water (ICW) as TBW-ECW. Hydration status was assessed by urine-specific gravity (USG) using a refractometer. Fat (FM) and FFM were assessed by dual-energy X-ray absorptiometry (DXA). The FFM hydration was calculated by TBW/FFM. The USG was statistically different between groups for females (LOW: 1.024 ± 0.003; HIGH: 1.015 ± 0.006; p = 0.005) and males (LOW: 1.024 ± 0.002; HIGH: 1.018 ± 0.005; p < 0.001). No differences between groups were detected in body water compartments and FFM hydration in both sexes (p > 0.05). Multiple regression showed that WI remains a predictor of USG regardless of FFM, age, and sex (ß = -0.0004, p < 0.01). We concluded that LOW athletes were classified as dehydrated through USG although their water compartments were not different from HIGH athletes. These results suggest that LOW athletes may expectedly maintain the body water compartments' homeostasis through endocrine mechanisms. Interventions should be taken to encourage athletes to have sufficient WI to maintain optimal hydration.

Prediction of body water compartments by raw bioelectrical impedance parameters in athletes: Comparison between series and parallel measurements.

BACKGROUND: The aim of this study was to determine the predictive role of series and parallel bioelectrical impedance-derived parameters in predicting total body (TBW), intracellular (ICW), and extracellular water (ECW) in athletes. METHODS: This cross-sectional study analyzed 134 male (21.33 ± 5.11 years) and 64 female (20.45 ± 5.46 years) athletes. Using dilution techniques, TBW and ECW were determined while ICW was the difference between both. Raw and standardized for height (/H) bioelectrical resistance (R), reactance (Xc), and impedance (Z) values were obtained using a phase-sensitive device at a single frequency in a series array (s). These were mathematically transformed in a parallel array (p) and capacitance (CAP). Fat-free mass (FFM) was assessed by dual-energy X-ray absorptiometry. RESULTS: Multiple regressions adjusted for age and FFM show that R/Hs, Z/Hs, R/Hp, and Z/Hp were significant predictors of TBW (p < 0.001 in females and males). While Xc/Hs did not predict ICW, Xc/Hp was a predictor (p < 0.001 in females and Males). In females, R/H and Z/H predicted similarly TBW, ICW, and ECW. In males, R/Hs was considered a better predictor than R/Hp for TBW and ICW, and the Xc/Hp was considered the best predictor for ICW. Another significant predictor of ICW was CAP (p < 0.001 in females and males). CONCLUSION: This study highlights the potential value of parallel bioelectrical impedance values to identify fluid compartments in athletes as an alternative to the regularly used series measurements. Moreover, this study supports Xc in parallel, and ultimately CAP, as valid indicators of cell volume.

Comparison of series and parallel reactance to identify changes in intracellular water in response to physical training in athletes during a sports season.

OBJECTIVE: Cross-sectional evidence has demonstrated that parallel reactance obtained by bioelectrical impedance analysis (BIA) may be an alternative to the regularly used series of measurements to predict intracellular water (ICW) in athletes. However, we are not aware of any studies that have determined the predictive role or compared the effectiveness of both series and parallel reactance for tracking ICW changes during an athletic season. The main aim of this study was to determine the predictive role and compare both series and parallel reactance (Xc) in tracking ICW during an athletic season. RESEARCH METHODS AND PROCEDURES: This longitudinal study analyzed 108 athletes in the preparatory and competitive periods. Using dilution techniques, total body water (TBW) and extracellular water (ECW) were determined and ICW was calculated. Resistance (R), Xc, and impedance (Z) standardized for height were obtained through BIA spectroscopy using a frequency of 50kHz in a series array and then mathematically transformed in a parallel array. RESULTS: Multiple regression analyses showed that only changes in parallel Xc and capacitance (CAP) (P < 0.05) were predictors of delta ICW during the sports season. In contracts, this was not the case for Xcs. Both changes in R and Z, series and parallel, predicted similarly the changes in ECW and TBW (P < 0.05) in athletes. CONCLUSION: Our findings highlight the potential of parallel BIA values to detect changes in body water compartments over a competitive season. These data provide preliminary evidence that changes in parallel Xc/H, and ultimately CAP, represent valid markers of alterations in cell volume during a sports season.

Assessment of exercise-induced dehydration in underhydrated athletes: Which method shows the most promise?

BACKGROUND & AIMS: Athletes are commonly exposed to exercise-induced dehydration. However, the best method to detect dehydration under this circumstance is not clear. This study aimed to analyze pre- and post-dehydration measurements of biomarkers, including saliva osmolality (SOsm), urine osmolality (UOsm), urine-specific gravity (USG), urine color (Ucolor), serum osmolality (SeOsm), serum arginine vasopressin (AVP), serum sodium (Na+), and thirst sensation in underhydrated athletes, using the body mass loss (BML) as the reference method. METHODS: In this clinical trial (NCT05380089), a total of 38 athletes (17 females) with a regular low water intake (<35 mL/kg/day) were submitted to exercise-induced dehydration with a heat index of 29.8 ± 3.1 °C and an individualized running intensity (80-90% of first ventilatory threshold). RESULTS: ROC curve analysis revealed significant discriminative abilities of SOsm, with AUC values of 0.76 at 1.5% BML, 0.75 at 1.75% BML, and 0.87 at 2% BML, while Na+ and SeOsm showed the highest AUC of 0.87 and 0.91 at 2% BML, respectively. SOsm showed high sensitivity at 1.5% of BML, while SeOsm and Na+ demonstrated high sensitivity at 2% of BML. CONCLUSION: This study highlights SOsm as a potential indicator of hydration status across different levels of BML. Additionally, Na+ and SeOsm emerged as accurate dehydration predictors at 1.75% and 2% of BML. Notably, the accuracy of urinary indices and thirst sensation for detecting hydration may be limited.

Does acute dehydration affect the neuromuscular function in healthy adults?-a systematic review.

The effects of acute dehydration on neuromuscular function have been studied. However, whether the mechanisms underpinning such function are central or peripheral is still being determined, and the results are inconsistent. This systematic review aims to elucidate the influence of acute dehydration on neuromuscular function, including a novel aspect of investigating the central and peripheral neuromuscular mechanisms. Three databases were used for the article search: PubMed, Web of Science, and Scopus. Studies were included if they had objective measurements of dehydration, muscle performance, and electromyography data or transcranial magnetic stimulation or peripheral nerve stimulation measurements with healthy individuals aged 18-65 years. Twenty-three articles met the eligibility criteria. The studies exhibited considerable heterogeneity in the methods used to induce and quantify dehydration. Despite being inconsistent, the literature shows some evidence that acute dehydration does not affect maximal strength during isometric or moderate-speed isokinetic contractions. Conversely, acute dehydration significantly reduces maximal strength during slow-speed isokinetic contractions and fatigue resistance in response to endurance tasks. The studies report that dehydration does not affect the motor cortical output or spinal circuity. The effects occur at the peripheral level within the muscle.

Immune cell changes in response to a swimming training session during a 24-h recovery period.

Understanding the impact of training sessions on the immune response is crucial for the adequate periodization of training, to prevent both a negative influence on health and a performance impairment of the athlete. This study evaluated acute systemic immune cell changes in response to an actual swimming session, during a 24-h recovery period, controlling for sex, menstrual cycle phases, maturity, and age group. Competitive swimmers (30 females, 15 ± 1.3 years old; and 35 males, 16.5 ± 2.1 years old) performed a high-intensity training session. Blood samples were collected before, immediately after, 2 h after, and 24 h after exercise. Standard procedures for the assessment of leukogram by automated counting (Coulter LH 750, Beckman) and lymphocytes subsets by flow cytometry (FACS Calibur BD, Biosciences) were used. Subjects were grouped according to competitive age groups and pubertal Tanner stages. Menstrual cycle phase was monitored. The training session induced neutrophilia, lymphopenia, and a low eosinophil count, lasting for at least 2 h, independent of sex and maturity. At 24 h postexercise, the acquired immunity of juniors (15-17 years old), expressed by total lymphocytes and total T lymphocytes (CD3(+)), was not fully recovered. This should be accounted for when planning a weekly training program. The observed lymphopenia suggests a lower immune surveillance at the end of the session that may depress the immunity of athletes, highlighting the need for extra care when athletes are exposed to aggressive environmental agents such as swimming pools.