Abstract
Dehydration not only reduces athletic performance, but also places athletes at risk of health problems and even death. For athletes, monitoring hydration has significant value in maximising performance during training and competition. It also offers medical personnel the opportunity to reduce health risks in situations where athletes engage in intentional weight loss. Simple non-invasive techniques, including weight monitoring and urine tests, can provide useful information. Bioimpedance methods tend to be easy to use and fairly inexpensive, but generally lack the precision and accuracy necessary for hydration monitoring. Blood tests appear to be the most accurate monitoring method, but are impractical because of cost and invasiveness. Although future research is needed to determine which hydration tests are the most accurate, we encourage sports teams to develop and implement hydration monitoring protocols based on the currently available methods. Medical personnel can use this information to maximise their team’s athletic performance and minimise heat- and dehydration-related health risks to athletes.
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References
Occupational Safety and Health Department. Report on the Minnesota Viking football training camp. St Paul (MN): Minnesota Department of Labor and Industry, 2001
Mueller FO. Annual survey of football injury research: 1931–2001. Chapel Hill (NC): National Center for Catastrophic Sports Injuries, 2002 Feb
Centers for Disease Control and Prevention. Hyperthermia and dehydration-related deaths associated with intentional rapid weight loss in three collegiate wrestlers: North Carolina, Wisconsin, and Michigan; November - December 1997. JAMA 1998; 279: 824–5
Powell J, Barber-Foss K. Sex-related injury patterns among selected high school sports. Am J Sports Med 2000; 28: 385–91
American College of Sports Medicine. Position statement: exercise and fluid replacement for athletes. Med Sci Sports Exerc 1996; 28: I-VII
Casa DJ, Armstrong LE, Hillman SK, et al. National Athletic Trainers’ Association position statement: fluid replacement for athletes. J Athletic Training 2000; 35: 212–24
American College of Sports Medicine. Joint position statement: nutrition and athletic performance. Med Sci Sports Exerc 2000; 32: 2130–45
Greenleaf JE. Problem: thirst, drinking behavior, and involuntary dehydration. Med Sci Sports Exerc 1992; 24: 645–56
Wrestling Rules Committee. NCAA wrestling rules. Indianapolis (IN): NCAA Publications, 1999
Clark RR, Oppliger RA. Minimal weight standards in high school wrestling. Orthop Phys Ther Clin North Am 1998; 7: 23–45
Sawka MN. Physiological consequences of hypohydration: exercise performance and thermoregulation. Med Sci Sports Exerc 1992; 24: 657–70
Wang ZM, Pierson RN, Heymsfield SB. The five-level model: a new approach to organizing body composition research. Am J Clin Nutr 1992; 56: 19–28
Sawka MN, Pandolf KB. Effects of body water loss on physiological function and exercise performance. In: Gisolfi CV, Lamb DR, editors. Fluid homeostasis during exercise. Carmel (IN): Benchmark Press, 1990: 1–38
Weinberg AD, Minaker KL, American Medical Association CoSA. Dehydration: evaluation and management in older adults. JAMA 1995; 274: 1552–6
Sawka MN, Montain SJ, Latzka WA. Hydration effects on the thermoregulation and performance in the heat. Comp Biochem Physiol A 2001; 128: 679–90
Oppliger RA, Landry GL, Foster SW, et al. Wisconsin minimum weight program reduces weight cutting practices of high school wrestlers. Clin J Sports Med 1998; 8: 26–31
Steen SN, Brownell KD. Patterns of weight loss and regain in wrestlers: has the tradition changed? Med Sci Sports Exerc 1990; 22: 762–8
Brownell KD, Steen SN, Wilmore JH. Weight regulation practices in athletes: analysis of metabolic and health effects. Med Sci Sports Exerc 1987; 19: 546–56
Steen SN, Oppliger RA, Brownell KA. Metabolic effects of repeated weight loss and regain in adolescent wrestlers. JAMA 1988; 260: 47–50
Rosen LW, McKeag DB, Hough DO, et al. Pathogenic weight control behavior in female athletes. Phys Sportsmed 1986; 14: 79–86
Sundgot-Borgen J. Eating disorders in female athletes. Sports Med 1994; 17: 176–88
Popowski LA, Oppliger RA, Lambert P, et al. Blood and urinary measures of hydration status during progressive acute dehydration. Med Sci Sports Exerc 2001; 33: 747–53
Costill DL, Sparks KE. Rapid fluid replacement following thermal dehydration. J Appl Physiol 1973; 34: 299–303
Strasinger SK. Urinalysis and body fluids. Philadelphia (PA): FA Davis Company, 1994
Shirreffs SM, Maughan RJ. Urine osmolality and conductivity as indices of hydration status in athletes in the heat. Med Sci Sports Exerc 1998; 30: 1598–602
Brunzel NA. Fundamentals of urine and body fluid analysis. Philadelphia (PA): WB Saunders Company, 1994
Armstrong LE, Maresh CM, Casellani JW, et al. Urinary indices of hydration status. Int J Sport Nutr 1994; 4: 265–79
Armstrong LE, Maresh CM, Gabaree CV, et al. Thermal and circulatory responses during exercise: effects of hypohydration, dehydration, and water intake. J Appl Physiol 1997; 82: 2028–35
Francesconi RP, Hubbard RW, Szlyk PC, et al. Urinary and hematologic indexes of hypohydration. J Appl Physiol 1987; 62: 1271–6
Kovacs EMR, Senden JMG, Brouns F. Urine color, osmolality, and specific electrical conductance are not accurate measures of hydration status during post exercise rehydration. J Sports Med Phys Fitness 1999; 39: 47–53
Armstrong LE, Soto JAH, Hacker FT, et al. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr 1998; 8: 345–55
Hackney AC, Coyne JT, Pozos R, et al. Validity of urine blood hydrational measures to asses total body water changes during a mountaineering in the sub-Arctic. Arctic Med Res 1995; 54: 69–77
Nose H, Mack GW, Shi X, et al. Shift in body fluid compartments after dehydration in humans. J Appl Physiol 1988; 65: 318–24
Baumgartner RN. Electrical impedance and total body electrical conductivity. In: Roche AF, Heymsfield SB, Lohman TG, editors. Human body composition. Champaign (IL): Human Kinetics, 1996: 79–107
Gudivaka R, Schoeller DA, Kushner RF, et al. Single- and multifrequency models for bioelectrical impedance analysis of body water compartments. J Appl Physiol 1999; 87: 1087–96
Kushner RF, Gudivaka R, Schoeller DA. Clinical characteristics influencing bioelectrical impedance analysis measurements. Am J Clin Nutr 1996; 64 (3 Suppl.): 423S-7S
Anonymous. NIH Technology assessment statement: bioelectrical impedance analysis in body composition measurement. Bethesda (MD): National Institute of Health, 1994: 1–35
Thompson DL, Thompson WR, Prestridge TJ, et al. Effects of hydration and dehydration on body composition analysis: a comparative study of bioelectric impedance analysis and hydrodensitometry. J Sports Med Phys Fitness 1991; 31: 565–70
Saunders MJ, Blevins JE, Broeder CE. Effects of hydration changes on bioelectrical impedance in endurance trained individuals. Med Sci Sports Exerc 1998; 30: 885–92
Koulmann N, Jimenez C, Regal D, et al. Use of bioelectrical impedance analysis to estimate body fluid compartments after acute variations of the body hydration level. Med Sci Sports Exerc 2000; 32: 857–64
O’Brien C, Baker-Fulco CJ, Young AJ, et al. Bioimpedance assessment of hypohydration. Med Sci Sports Exerc 1999; 31: 1466–71
Segal KR. Use of bioelectrical impedance analysis measurements as an evaluation for participating in sports. Am J Clin Nutr 1996; 64 (3 Suppl.): 469S-71S
Zambraski EJ, Tipton CM, Jordon HR, et al. Iowa wrestling study: urinary profiles of state finalists prior to competition. Med Sci Sports Exerc 1974; 6: 129–32
Zambraski EJ, Tipton CM, Tcheng TK, et al. Iowa wrestling study: changes in the urinary profiles prior to and after competition. Med Sci Sports Exerc 1975; 7: 217–20
Zambraski EJ, Foster DT, Gross PM, et al. Iowa wrestling study: weight loss and urinary profiles of collegiate wrestlers. Med Sci Sports Exerc 1976; 8: 105–8
Acknowledgments
We appreciate the constructive comments from Jonathan Olson, M.S., Dale A. Schoeller, Ph.D., Randy W. Dick, and Alan C. Utter, Ph.D. Robert Oppliger received no external support for his time and has no conflicts of interest. Cynthia Bartok was supported by a training grant from the National Institutes of Health and has no conflicts of interest.
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Oppliger, R.A., Bartok, C. Hydration Testing of Athletes. Sports Med 32, 959–971 (2002). https://doi.org/10.2165/00007256-200232150-00001
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DOI: https://doi.org/10.2165/00007256-200232150-00001