Markers of the hydration process during fluid volume modification in women with habitual high or low daily fluid intakes
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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.
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 (Sosmo), total plasma protein (TPP), 24 h urine osmolality, and 24 h urine volume, were measured on each day of modified TWI. Estimated plasma volume (Epv) was calculated using measured body mass and hematocrit values.
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) Epv 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−1p < 0.001], and (4) no changes of serum osmolality occurred in either HIGH or LOW (all p > 0.05).
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.
KeywordsHydration indices Fluid intake Osmolality Hydration status Fluid regulation
Estimated plasma volume
Participant group that habitually consumed 3.34 (0.56) L day−1
Participant group that habitually consumed 1.62 (0.48) L day−1
- Serum Cl−
Serum chloride (mmol L−1)
- Serum K+
Serum potassium (mmol L−1)
- Serum Na+
Serum sodium (mmol L−1)
Serum osmolality (mOsm kg−1)
Total plasma protein (mg dL−1)
Total water intake including water from food and beverages
Urine osmolality (mOsm kg-1)
Urine specific gravity
Volume of urine produced in 24 h urine collection (L)
The authors are grateful to Brittany Swokla, Amy McKenzie, Jenna Appicella, Daniel Friedenreich, Holly Emmanuel, Brittanie Volk, Cathy Saenz, Colin Shaughnessy, Theodore Pert III, Ethan Talbot, Corey Dwyer, and Katie Simpson for their technical assistance during data collection and analysis.
Conflict of interest
The current investigation was supported by a grant from DANONE Research. Lawrence Armstrong serves on the Scientific Advisory Board for, and Laurent Le Bellego and Alexis Klien are employees at, DANONE Research.