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Fluid Replacement and Exercise Stress

A Brief Review of Studies on Fluid Replacement and Some Guidelines for the Athlete

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Summary

Fluid ingestion during exercise has the twin aims of providing a source of carbohydrate fuel to supplement the body’s limited stores and of supplying water and electrolytes to replace the losses incurred by sweating. Increasing the carbohydrate content of drinks will increase the amount of fuel which can be supplied, but will tend to decrease the rate at which water can be made available; where provision of water is the first priority, the carbohydrate content of drinks will be low, thus restricting the rate at which substrate is provided. The composition of drinks to be taken will thus be influenced by the relative importance of the need to supply fuel and water; this in turn depends on the intensity and duration of the exercise task, on the ambient temperature and humidity, and on the physiological and biochemical characteristics of the individual athlete. Carbohydrate ingested during exercise appears to be readily available as a fuel for the working muscles, at least when the exercise intensity does not exceed 70 to 75% of maximum oxygen uptake. Carbohydrate-containing solutions appear to be more effective in improving performance than plain water. Water and electrolytes are lost from the body in sweat: although the composition of sweat is rather variable, it is invariably hypotonic with respect to plasma. Sweat rate is determined primarily by the metabolic rate and the environmental temperature and humidity. The sweat rate may exceed the maximum rate of gastric emptying of ingested fluids, and some degree of dehydration is commonly observed. Excessive-replacement of sweat losses with plain water or fluids with a low sodium content may result in hyponatraemia. Sodium replacement is essential for postexercise rehydration. The optimum frequency, volume and composition of drinks will vary widely depending on the intensity and duration of the exercise, the environmental conditions and the physiology of the individual. The athlete must determine by trial and error the most suitable regimen.

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References

  • Ahlborg B, Bergstrom J, Brohult J, Ekelund L-G, Hultman E, Maschio E. Human muscle glycogen content and capacity for prolonged exercise after different diets. Forsvarsmedicin 3: 85–99, 1967

    Google Scholar 

  • American College of Sports Medicine. Position statement on prevention of heat injuries during distance running. Medicine and Science in Sports 7: VII–IX, 1975

    Google Scholar 

  • American College of Sports Medicine. Position stand on prevention of thermal injuries during distance running. Medicine and Science in Sports and Exercise 16: IX–XIV, 1984

    Google Scholar 

  • Armstrong LE, Costill DL, Fink WJ. Influence of diuretic-induced dehyration on competitive running performance. Medicine and Science in Sports and Exercise 17: 456–461, 1985

    Article  PubMed  CAS  Google Scholar 

  • Barr SI, Costill DL. Water: can the endurance athlete get too much of a good thing. Journal of the American Diabetic Association 89: 1629–1632, 1989

    CAS  Google Scholar 

  • Bjorkman O, Sahlin K, Hagenfeldt L, Wahren J. Influence of glucose and fructose ingestion on the capacity for long-term exercise in well-trained men. Clinical Physiology 4: 483–494, 1984

    Article  PubMed  CAS  Google Scholar 

  • Brener W, Hendrix TR, McHugh PR. Regulation of the gastric emptying of glucose. Gastroenterology 85: 76–82, 1983

    PubMed  CAS  Google Scholar 

  • Brooke JD, Davies GJ, Green LF. The effects of normal and glucose syrup work diets on the performance of racing cyclists. Journal of Sports Medicine 15: 257–265, 1975

    CAS  Google Scholar 

  • Brouns F, Saris WHM, Rehrer NJ. Abdominal complaints and gastrointestinal function during long-lasting exercise. International Journal of Sports Medicine 8: 175–189, 1987

    Article  PubMed  CAS  Google Scholar 

  • Cade R, Spooner G, Schlein E, Pickering M, Dean R. Effect of fluid, electrolyte, and glucose replacement on performance, body temperature, rate of sweat loss and compositional changes of extracellular fluid. Journal of Sports Medicine and Physical Fitness 12: 150–156, 1972

    PubMed  CAS  Google Scholar 

  • Carter JE, Gisolfi CV. Fluid replacement during and after exercise in the heat. Medicine and Science in Sports and Exercise 21: 532–539, 1989

    PubMed  CAS  Google Scholar 

  • Coggan AR, Coyle EF. Effect of carbohydrate feedings during high-intensity exercise. Journal of Applied Physiology 65: 1703–1709, 1988

    PubMed  CAS  Google Scholar 

  • Coggan AR, Coyle EF. Metabolism and performance following carbohydrate ingestion late in exercise. Medicine and Science in Sports and Exercise 21: 59–65, 1989

    Article  PubMed  CAS  Google Scholar 

  • Convertino VA, Brock PJ, Keil LC, Bernauer EM, Greenleaf JE. Exercise training-induced hypervolemia: role of plasma albumin, renin and vasopressin. Journal of Applied Physiology 48: 665–669, 1980

    PubMed  CAS  Google Scholar 

  • Convertino VA, Keil LC, Greenleaf JE. Plasma volume, renin, and vasopressin responses to graded exercise after training. Journal of Applied Physiology 54: 508–514, 1983

    PubMed  CAS  Google Scholar 

  • Costill DL, Bennett A, Branam G, Eddy D. Glucose ingestion at rest and during prolonged exercise. Journal of Applied Physiology 34: 764–769, 1973

    PubMed  CAS  Google Scholar 

  • Costill DL, Saltin B. Factors limiting gastric emptying during rest and exercise. Journal of Applied Physiology 37: 679–683, 1974

    PubMed  CAS  Google Scholar 

  • Coyle EF, Coggan AR. Effectiveness of carbohydrate feeding in delaying fatigue during prolonged exercise. Sports Medicine 1: 446–458, 1984

    Article  PubMed  CAS  Google Scholar 

  • Coyle EF, Coggan AR, Hemmert MK, Ivy JL. Muscle glycogen utilisation during prolonged strenuous exercise when fed carbohydrate. Journal of Applied Physiology 61: 165–172, 1986

    PubMed  CAS  Google Scholar 

  • Coyle EF, Hagberg JM, Hurley BF, Martin WH, Ehsani AH, et al. Carbohydrate feeding during prolonged strenuous exercise can delay fatigue. Journal of Applied Physiology 55: 230–235, 1983

    PubMed  CAS  Google Scholar 

  • Davidson RJL, Robertson JD, Galea G, Maughan RJ. Haematological changes associated with marathon running. International Journal of Sports Medicine 8: 19–25, 1987

    Article  PubMed  CAS  Google Scholar 

  • Davies CTM, Thompson MW. Aerobic performance of female marathon and male ultramarathon athletes. European Journal of Applied Physiology 41: 233–245, 1979

    Article  CAS  Google Scholar 

  • Deschamps A, Levy RD, Cosio MG, Marliss EB, Magder S. Effect of saline infusion on body temperature and endurance during heavy exercise. Journal of Applied Physiology 66: 2799–2804, 1989

    PubMed  CAS  Google Scholar 

  • Duchman SM, Blieler TL, Schedl HP, Summers RW, Gisolfi CV. Effects of gastric function on intestinal composition of oral rehydration solutions. Medicine and Science in Sports and Exercise 22 (Suppl.): S89, 1990

    Google Scholar 

  • Erickson MA, Schwartzkopf RJ, McKenzie RD. Effects of caffeine, fructose, and glucose ingestion on muscle glycogen utilisation during exercise. Medicine and Science in Sports and Exercise 19: 579–583, 1987

    PubMed  CAS  Google Scholar 

  • Felig P, Cherif A, Minigawa A, Wahren J. Hypoglycaemia during prolonged exercise in normal men. New England Journal of Medicine 306: 895–900, 1982

    Article  PubMed  CAS  Google Scholar 

  • Fielding RA, Costill DL, Fink WJ, King DS, Hargreaves M, et al. Effect of carbohydrate feeding frequencies on muscle glycogen use during exercise. Medicine and Science in Sports and Exercise 17: 472–476, 1985

    Article  PubMed  CAS  Google Scholar 

  • Flynn MG, Costill DL, Hawley JA, Fink WJ, Neufer PD, et al. Influence of selected carbohydrate drinks on cycling performance and glycogen use. Medicine and Science in Sports and Exercise 19: 37–40, 1987

    PubMed  CAS  Google Scholar 

  • Fordtran JS. Stimulation of active and passive sodium absorption by sugars in the human jejunum. Journal of Clinical Investigation 55: 728–737, 1975

    Article  PubMed  CAS  Google Scholar 

  • Fordtran JS, Saltin B. Gastric emptying and intestinal absorption during prolonged severe exercise. Journal of Applied Physiology 23: 331–335, 1967

    Article  PubMed  CAS  Google Scholar 

  • Foster C, Costill DL, Fink WJ. Gastric emptying characteristics of glucose and glucose polymers. Research Quarterly 51: 299–305, 1980

    CAS  Google Scholar 

  • Fruth JM, Gisolfi CV. Effects of carbohydrate consumption on endurance performance: fructose versus glucose. In Fox EL (Ed.) Nutrient utilisation during exercise, pp. 68–75, Ross Laboratories, Columbus, 1983

    Google Scholar 

  • Greenhaff PL, Clough PJ. Predictors of sweat loss in man during prolonged exercise. European Journal of Applied Physiology 58: 348–352, 1989

    Article  CAS  Google Scholar 

  • Hallberg L, Magnusson B. The aetiology of sports anaemia. Acta Medica Scandinavica 216: 145–148, 1984

    Article  Google Scholar 

  • Hargreaves M, Briggs CA. Effect of carbohydrate ingestion on exercise metabolism. Journal of Applied Physiology 65: 1553–1555, 1988

    PubMed  CAS  Google Scholar 

  • Hargreaves M, Costill DL, Coggan A, Fink WJ, Nishibata I. Effect of carbohydrate feedings on muscle glycogen utilisation and exercise performance. Medicine and Science in Sports and Exercise 16: 219–222, 1984

    PubMed  CAS  Google Scholar 

  • Ivy J, Costill DL, Fink WJ, Lower RW. Influence of caffeine and carbohydrate feedings on endurance performance. Medicine and Science in Sports 11: 6–11, 1979

    PubMed  CAS  Google Scholar 

  • Ivy JL, Miller W, Dover V, Goodyear LG, Sherman WM, et al. Endurance improved by ingestion of a glucose polymer supplement. Medicine and Science in Sports and Exercise 15: 466–471, 1983

    PubMed  CAS  Google Scholar 

  • Jones BJM, Brown BE, Loran JS, Edgerton D, Kennedy JF. Glucose absorption from starch hydrolysates in the human jejunum. Gut 24: 1152–1160, 1983

    Article  PubMed  CAS  Google Scholar 

  • Jones BJM, Higgins BE, Silk DBA. Glucose absorption from maltotriose and glucose oligomers in the human jejunum. Clinical Science 72: 409–414, 1987

    PubMed  CAS  Google Scholar 

  • Kingwell B, McKenna MJ, Sandstrom ER, Hargreaves M. Effect of glucose polymer ingestion on energy and fluid balance during exercise. Journal of Sports Science 7: 3–8, 1989

    Article  CAS  Google Scholar 

  • Lamb DR, Brodowicz GR. Optimal use of fluids of varying formulations to minimize exercise-induced disturbances in homeostasis. Sports Medicine 3: 247–274, 1986

    Article  PubMed  CAS  Google Scholar 

  • Leatt P. The effect of glucose polymer ingestion on skeletal muscle glycogen depletion during soccer match-play and its resynthesis following a match. M.Sc. Thesis, University of Toronto, 1986

    Google Scholar 

  • Leiper JB, Maughan RJ. Experimental models for the investigation of water and solute transport in man: implications for oral rehydration solutions. Drugs 36(Suppl. 4): 65–79, 1988

    Article  PubMed  Google Scholar 

  • Lolli G, Greenberg LA, Lester D. The influence of carbonated water on gastric emptying. New England Journal of Medicine 246: 490–492, 1952

    Article  PubMed  CAS  Google Scholar 

  • Macaraeg PVJ. Influence of carbohydrate electrolyte ingestion on running endurance. In Fox EL (Ed.) Nutrient utilisation during exercise, pp. 91–96, Ross Laboratories, Columbus, 1983

    Google Scholar 

  • McArthur KE, Feldman M. Gastric acid secretion, gastrin release, and gastric temperature in humans as affected by liquid meal temperature. American Journal of Clinical Nutrition 49: 51–54, 1989

    PubMed  CAS  Google Scholar 

  • Massicote D, Peronnet F, Brisson G, Bakkouch K, Hillaire-marcel C. Oxidation of a glucose polymer during exercise: comparison with glucose and fructose. Journal of Applied Physiology 1989; 66: 179–183

    Google Scholar 

  • Maughan RJ. Thermoregulation and fluid balance in marathon competition at low ambient temperature. International Journal of Sports Medicine 6: 15–19, 1985

    Article  PubMed  CAS  Google Scholar 

  • Maughan RJ. Carbohydrate-electrolyte solutions during prolonged exercise. In Lamb DR & Williams MH (Eds) Ergogenics: the enhancement of sports performance, pp. 35–85, Benchmark Press, 1991

    Google Scholar 

  • Maughan RJ, Leiper JB. Aerobic capacity and fractional utilisation of aerobic capacity in elite and non-elite male and female marathon runners. European Journal of Applied Physiology 52: 80–87, 1983

    Article  CAS  Google Scholar 

  • Maughan RJ, Whiting PH. Factors influencing plasma glucose concentration during marathon running. In Dotson CO & Humphrey JH (Eds) Exercise physiology, Vol. 1, pp. 87–98, AMS Press, New York, 1985

    Google Scholar 

  • Maughan RJ, Fenn CE, Gleeson M, Leiper JB. Metabolic and circulatory responses to the ingestion of glucose polymer and glucose/electrolyte solutions during exercise in man. European Journal of Applied Physiology 56: 356–362, 1987

    Article  CAS  Google Scholar 

  • Maughan RJ, Fenn CE, Leiper JB. Effects of fluid, electrolyte and substrate ingestion on endurance capacity. European Journal of Applied Physiology 58: 481–486, 1989

    Article  CAS  Google Scholar 

  • Maughan RJ, Leiper JB, McGaw BA. Effects of exercise intensity on absorption of ingested fluids in man. Experimental Physiology 75: 419–421, 1990

    PubMed  CAS  Google Scholar 

  • Mitchell D, Senay LC, Wyndham CH, van Rensburg AJ, Rogers GG, et al. Acclimatization in a hot, humid environment: energy exchange, body temperature, and sweating. Journal of Applied Physiology 40: 768–778, 1976

    PubMed  CAS  Google Scholar 

  • Mitchell JB, Costill DL, Houmard JA, Flynn MG, Fink WJ, et al. Effects of carbohydrate ingestion on gastric emptying and exercise performance. Medicine and Science in Sports and Exercise 20: 110–115, 1988

    Article  PubMed  CAS  Google Scholar 

  • Murray R. The effects of consuming carbohydrate-electrolyte beverages on gastric emptying and fluid absorption during and following exercise. Sports Medicine 4: 322–351, 1987

    Article  PubMed  CAS  Google Scholar 

  • Murray R, Eddy DE, Murray TW, Seifert JG, Paul GL, Halaby GA. The effect of fluid and carbohydrate feedings during intermittent cycling exercise. Medicine and Science in Sports and Exercise 19: 597–604, 1987

    PubMed  CAS  Google Scholar 

  • Murray R, Paul GL, Seifert JG, Eddy DE, Halaby GA. The effects of glucose, fructose, and sucrose ingestion during exercise. Medicine and Science in Sports and Exercise 21: 275–282, 1989a

    PubMed  CAS  Google Scholar 

  • Murray R, Seifert JG, Eddy DE, Paul GL, Halaby GA. Carbohydrate feeding and exercise: effect of beverage carbohydrate content. European Journal of Applied Physiology 59: 152–158, 1989b

    Article  CAS  Google Scholar 

  • Nadel ER. Circulatory and thermal regulations during exercise. Federation Proceedings 39: 1491–1497, 1980

    PubMed  CAS  Google Scholar 

  • Naveri H, Tikkanen H, Kairento A-L, Harkonen M. Gastric emptying and serum insulin levels after intake of glucose-polymer solutions. European Journal of Applied Physiology 58: 661–665, 1989

    Article  CAS  Google Scholar 

  • Noakes TD. The dehydration myth and carbohydrate replacement during prolonged exercise. Cycling Science 23–29, 1990

    Google Scholar 

  • Noakes TD, Adams BA, Myburgh KH, Greeff C, Lotz T, et al. The danger of the inadequate water intake during prolonged exercise: a novel concept re-visited. European Journal of Applied Physiology 57: 210–219, 1988

    Article  CAS  Google Scholar 

  • Noakes TD, Goodwin N, Rayner BL, Branken T, Taylor RKN. Water intoxication: a possible complication during endurance exercise. Medicine and Science in Sports and Exercise 17: 370–375, 1985

    PubMed  CAS  Google Scholar 

  • Olsson KE, Saltin B. Diet and fluids in training and competition. Scandinavian Journal of Rehabilitation Medicine 3: 31–38, 1971

    PubMed  CAS  Google Scholar 

  • Pallikarakis N, Jandrain B, Pirnay F, Mosora F, Lacroix M, et al. Remarkable metabolic availability of oral glucose during long-duration exercise in humans. Journal of Applied Physiology 60: 1035–1042, 1986

    PubMed  CAS  Google Scholar 

  • Pirnay F, Lacroix M, Mosora F, Luyckx A, Lefebvre P. Glucose oxidation during prolonged exercise evaluated with naturally labeled [13C] glucose. Journal of Applied Physiology 43: 258–261, 1977

    CAS  Google Scholar 

  • Pirnay F, Crielaard JM, Pallikarakis N, Lacroix M, Mosora F, et al. Fate of exogenous glucose during exercise of different intensities in humans. Journal of Applied Physiology 53: 1620–1624, 1982

    PubMed  CAS  Google Scholar 

  • Rehrer NJ. Limits to fluid availability during exercise, De Vrieseborsch, Haarlem, 1990

    Google Scholar 

  • Rehrer NJ, Beckers E, Brouns F, Ten Hoor F, Saris WHM. Exercise and training effects on gastric emptying of carbohydrate beverages. Medicine and Science in Sports and Exercise 21: 540–549, 1989a

    PubMed  CAS  Google Scholar 

  • Rehrer NJ, Janssen GME, Brouns F, Saris WHM. Fluid intake and gastrointestinal problems in runners competing in a 25km race and a marathon. International Journal of Sports Medicine 10(Suppl. 1): S22–S25, 1989b

    Article  PubMed  Google Scholar 

  • Riley ML, Israel RG, Holbert D, Tapscott EB, Dohm GL. Effect of carbohydrate ingestion on exercise endurance and metabolism after a 1-day fast. International Journal of Sports Medicine 9: 320–324, 1988

    Article  PubMed  CAS  Google Scholar 

  • Robertson JD, Maughan RJ, Davidson RJL. Changes in red cell density and related parameters in response to long distance running. European Journal of Applied Physiology 57: 264–269, 1988

    Article  CAS  Google Scholar 

  • Rowell LB. Human circulation, Oxford University Press, New York, 1986

    Google Scholar 

  • Saltin B, Costill DL. Fluid and electrolyte balance during prolonged exercise. In Horton ES & Terjung RL (Eds) Exercise, nutrition and metabolism, pp. 150–158, Macmillan, New York, 1988

    Google Scholar 

  • Sasaki H, Maeda J, Usui S, Ishiko T. Effect of sucrose and caffeine ingestion on performance of prolonged strenuous running. International Journal of Sports Medicine 8: 261–265, 1987

    Article  PubMed  CAS  Google Scholar 

  • Senay LC. Effects of exercise in the heat on body fluid distribution. Medicine and Science in Sports 11: 42–48, 1979

    PubMed  Google Scholar 

  • Senay LC, Mitchell D, Wyndham CH. Acclimatization in a hot humid environment: body fluid adjustments. Journal of Applied Physiology 40: 786–796, 1976

    PubMed  CAS  Google Scholar 

  • Sole CC, Noakes TD. Faster gastric emptying for glucose-polymer and fructose solutions than for glucose in humans. European Journal of Applied Physiology 58: 605–612, 1989

    Article  CAS  Google Scholar 

  • Spiller RC, Jones BJM, Brown BE, Silk DBA. Enhancement of carbohydrate absorption by the addition of sucrose to enteric diets. Journal of Parenteral and Enteral Nutrition 6: 321, 1982

    Google Scholar 

  • Sun WM, Houghton LA, Read NW, Grundy DG, Johnson AG. Effect of meal temperature on gastric emptying of liquids in man. Gut 29: 302–305, 1988

    Article  PubMed  CAS  Google Scholar 

  • Suzuki Y. Human physical performance and cardiocirculatory responses to hot environments during sub-maximal upright cycling. Ergonomics 23: 527–542, 1980

    Article  PubMed  CAS  Google Scholar 

  • Wapnir RA, Lifshitz F. Osmolality and solute concentration — their relationship with oral rehydration solution effectiveness: an experimental assessment. Pediatric Research 19: 894–898, 1985

    Article  PubMed  CAS  Google Scholar 

  • Williams C. Diet and endurance fitness. American Journal of Clinical Nutrition 49: 1077–1083, 1989

    PubMed  CAS  Google Scholar 

  • Williams C, Nute MG, Broadbank L, Vinall S. Influence of fluid intake on endurance running performance: a comparison between water, glucose and fructose solutions. European Journal of Applied Physiology 60: 112–119, 1990

    Article  CAS  Google Scholar 

  • Wyndham CH, Rogers GG, Senay LC, Mitchell D. Acclimatization in a hot, humid environment: cardiovascular adjustments. Journal of Applied Physiology 40: 779–785, 1976

    PubMed  CAS  Google Scholar 

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  1. Department of Environmental and Occupational Medicine, University Medical School, Foresterhill, Aberdeen, AB9 2ZD, Scotland

    R. J. Maughan & T. D. Noakes

  2. Department of Physiology, Medical School, MRC/UCT Bioenergetics of Exercise Research Unit, Observatory, Cape, South Africa

    R. J. Maughan & T. D. Noakes

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Maughan, R.J., Noakes, T.D. Fluid Replacement and Exercise Stress. Sports Med 12, 16–31 (1991). https://doi.org/10.2165/00007256-199112010-00003

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