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Title: Are we being drowned in hydration advice? Thirsty for more?
Authors: Cotter, J.D
Thornton, S.N
Lee, J.K.W 
Laursen, P.B
Keywords: body distribution
body mass
cardiovascular disease
chronic kidney disease
environmental stress
extracellular space
fluid balance
heat stress
metabolic disorder
muscle cramp
outcome assessment
physical activity
priority journal
sports medicine
total body water
urinary tract infection
Issue Date: 2014
Citation: Cotter, J.D, Thornton, S.N, Lee, J.K.W, Laursen, P.B (2014). Are we being drowned in hydration advice? Thirsty for more?. Extreme Physiology and Medicine 3 (1) : Jan-16. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Hydration pertains simplistically to body water volume. Functionally, however, hydration is one aspect of fluid regulation that is far more complex, as it involves the homeostatic regulation of total body fluid volume, composition and distribution. Deliberate or pathological alteration of these regulated factors can be disabling or fatal, whereas they are impacted by exercise and by all environmental stressors (e.g. heat, immersion, gravity) both acutely and chronically. For example, dehydration during exercising and environmental heat stress reduces water volume more than electrolyte content, causing hyperosmotic hypohydration. If exercise continues for many hours with access to food and water, composition returns to normal but extracellular volume increases well above baseline (if exercising upright and at low altitude). Repeating bouts of exercise or heat stress does likewise. Dehydration due to physical activity or environmental heat is a routine fluid-regulatory stress. How to gauge such dehydration and- more importantly-what to do about it, are contested heavily within sports medicine and nutrition. Drinking to limit changes in body mass is commonly advocated (to maintain ?2% reduction), rather than relying on behavioural cues (mainly thirst) because the latter has been deemed too insensitive. This review, as part of the series on moving in extreme environments, critiques the validity, problems and merits of externally versus autonomously controlled fluid-regulatory behaviours, both acutely and chronically. Our contention is that externally advocated hydration policies (especially based on change in body mass with exercise in healthy individuals) have limited merit and are extrapolated and imposed too widely upon society, at the expense of autonomy. More research is warranted to examine whether ad libitum versus avid drinking is beneficial, detrimental or neither in: acute settings; adapting for obligatory dehydration (e.g. elite endurance competition in the heat), and; development of chronic diseases that are associated with an extreme lack of environmental stress. © 2014 Cotter et al.; licensee BioMed Central Ltd.
Source Title: Extreme Physiology and Medicine
ISSN: 20467648
Rights: Attribution 4.0 International
Appears in Collections:Staff Publications

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