Sports Medicine

, Volume 48, Issue 9, pp 2215–2217 | Cite as

Author’s Reply to Valenzuela et al.: Comment on “Drinking Strategies: Planned Drinking Versus Drinking to Thirst”

  • Robert W. Kenefick
Letter to the Editor

Dear Editor,

I have read the letter by Valenzuela et al. [1] regarding my review article entitled “Drinking strategies: planned drinking versus drinking to thirst” [2] and would like to address several misconceptions in the letter.

Valenzuela et al. [1] state that my final advice in the review is to “…avoid drinking to thirst in order to prevent BW losses > 2% during activities of high intensity or long duration (> 1–2 h), or when exercising in warm/hot environments” [2]. However, this statement is not accurate, the recommendation is to employ a tailored drinking program to avoid potential thermoregulatory, cardiovascular, and exercise performance impairment (2% body weight loss), particularly in the conditions described. This recommendation is particularly true for individuals with high sweat rates, who are heat-acclimatized or for those whose primary concern is optimal performance.

Valenzuela et al. [1] state that I describe incidences of hyponatremia as “rare,” which is also...



The views, opinions, and/or findings in this letter are those of the author and should not be construed as official Department of the Army or Department of Defense positions, policies, or decisions unless so designated by other official designation.

Compliance with Ethical Standards


No sources of funding were used to assist in the preparation of this letter.

Conflict of interest

Robert W. Kenefick has no conflicts of interest relevant to the content of this letter.


  1. 1.
    Valenzuela PL, Morales JS, de la Villa P, Lucia A. Comment on: “Drinking strategies: planned drinking versus drinking to thirst”. Sports Med. 2018.Google Scholar
  2. 2.
    Kenefick RW. Drinking strategies: planned drinking versus drinking to thirst. Sports Med. 2018;48(Suppl 1):31–7. Scholar
  3. 3.
    Hew-Butler T, Rosner MH, Fowkes-Godek S, Dugas JP, Hoffman MD, Lewis DP, et al. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Clin J Sport Med. 2015;25(4):303–20.CrossRefPubMedGoogle Scholar
  4. 4.
    Almond CSD, Thiagarajan RR, Piercey GE, Gauvreau K, Blume ED, Bastardi HJ, et al. Waiting list mortality among children listed for heart transplantation in the United States. Circulation. 2009;119(5):717–27.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Noakes TD, Sharwood K, Speedy D, Hew T, Reid S, Dugas J, et al. Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2135 weighed competitive athletic performances. Proc Natl Acad Sci USA. 2005;102(51):18550–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014;4(1):257–85.CrossRefPubMedGoogle Scholar
  7. 7.
    Goulet ED. Effect of exercise-induced dehydration on time-trial exercise performance: a meta-analysis. Br J Sports Med. 2011;45(14):1149–56.CrossRefPubMedGoogle Scholar
  8. 8.
    Goulet EDB. Effect of exercise-induced dehydration on endurance performance: evaluating the impact of exercise protocols on outcomes using a meta-analytic procedure. Br J Sports Med. 2013;47:679–86.CrossRefPubMedGoogle Scholar
  9. 9.
    Wall BA, Watson G, Peiffer JJ, Abbiss CR, Siegel R, Laursen PB. Current hydration guidelines are erroneous: dehydration does not impair exercise performance in the heat. Br J Sports Med. 2015;49(16):1077–83.CrossRefPubMedGoogle Scholar
  10. 10.
    Cheuvront SN, Kenefick RW, Montain SJ, Sawka MN. Mechanisms of aerobic performance impairment with heat stress and dehydration. J Appl Physiol. 2010;109(6):1989–95.CrossRefPubMedGoogle Scholar
  11. 11.
    James LJ, Moss J, Henry J, Papadopoulou C, Mears SA. Hypohydration impairs endurance performance: a blinded study. Physiol Rep. 2017; 5(12).Google Scholar
  12. 12.
    Adams JD, Sekiguchi Y, Suh HG, Seal AD, Sprong CA, Kirkland TW, et al. Dehydration impairs cycling performance, independently of thirst: a blinded study. Med Sci Sports Exerc. 2018.Google Scholar
  13. 13.
    Dion T, Savoie FA, Asselin A, Gariepy C, Goulet ED. Half-marathon running performance is not improved by a rate of fluid intake above that dictated by thirst sensation in trained distance runners. Eur J Appl Physiol. 2013;113(12):3011–20.CrossRefPubMedGoogle Scholar
  14. 14.
    Dugas JP, Oosthuizen U, Tucker R, Noakes TD. Rates of fluid ingestion alter pacing but not thermoregulatory responses during prolonged exercise in hot and humid conditions with appropriate convective cooling. Eur J Appl Physiol. 2009;105(1):69–80.CrossRefPubMedGoogle Scholar
  15. 15.
    Cheuvront SN, Kenefick RW, Ely BR, Harman EA, Castellani JW, Frykman PN, et al. Hypohydration reduces vertical ground reaction impulse but not jump height. Eur J Appl Physiol. 2010;109(6):1163–70.CrossRefPubMedGoogle Scholar
  16. 16.
    Dill DB, Bock AV, Edwards HT. Mechanisms for dissipating heat in man and dog. Am J Physiol. 1933;104:36–43.Google Scholar
  17. 17.
    Bean WB, Eichna LW. Performance in relation to environmental temperature: reactions of normal young men to simulated desert environment. Fed Proc. 1945;2(3):144–58.Google Scholar
  18. 18.
    Eichna LW, Bean WB, Ashe WF, Nelson N. Performance in relation to environmental temperature. Reactions of normal young men to hot, humid (simulated jungle) environment. Bull Johns Hopkins Hosp. 1945;76(1):25–58.Google Scholar
  19. 19.
    Adolf EF, Barker JP, Hoy PA. Multiple factors in thirst. Am J Physiol. 1954;178(3):538–62.Google Scholar
  20. 20.
    Robinson S, Turrell ES, Belding HS, Horvath SM. Rapid acclimatization to work in hot climates. Am J Physiol. 1943;140:168–76.Google Scholar
  21. 21.
    Black DAK, McCance RA, Young WF. A study of dehydration by means of balance experiments. J Physiol. 1944;102:406–14.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing (Outside the USA) 2018

Authors and Affiliations

  1. 1.Thermal and Mountain Medicine DivisionUS Army Research InstituteNatickUSA

Personalised recommendations