Water intake, pleasure and water temperature in humans

Fluid balance during physical work in the heat is not modified by the menstrual cycle when fluids are freely available

We tested the hypothesis that women may be more at risk of becoming dehydrated during physical work in the heat in the early follicular phase (EF), compared with the late follicular (LF) and mid-luteal (ML) phases of the menstrual cycle when allowed free access to drink. Twelve healthy, eumenorrheic, unacclimated women (26 ± 5 yr) completed three trials (EF, LF, and ML phases) involving 4 h of exposure to 33.8 ± 0.8 °C, 54 ± 1% relative humidity. Each hour, participants walked on a treadmill for 30 min at a rate of metabolic heat production of 338 ± 9 W. Participants drank a cool, flavor-preferred non-caloric sport drink ad libitum. Nude body weight was measured pre- and post-exposure, and percent changes in body weight loss were interpreted as an index of changes in total body water. Total fluid intake and urine output were measured and sweat rate was estimated from changes in body mass corrected for fluid intake and urine output. Fluid intake was not different between phases (EF: 1,609 ± 919 mL; LF: 1,902 ± 799 mL; ML: 1,913 ± 671; P = 0.202). Total urine output (P = 0.543) nor sweat rate (P = 0.907) differed between phases. Percent changes in body mass were not different between phases (EF: -0.5 ± 0.9%; LF: -0.3 ± 0.9%; ML: -0.3 ± 0.7%; P = 0.417). This study demonstrates that the normal hormonal fluctuations that occur throughout the menstrual cycle do not alter fluid balance during physical work in the heat.NEW & NOTEWORTHY The effect of the menstrual cycle on fluid balance during physical work in the heat when fluids are freely available is unknown. This study demonstrates that fluid balance is not modified in women across three distinct phases of the menstrual cycle during physical work in the heat These results indicate that when women have free access to cool fluid during physical work in the heat, they respond similarly across all three phases to maintain fluid homeostasis across the menstrual cycle.

Comparisons of isomaltulose, sucrose, and mixture of glucose and fructose ingestions on postexercise hydration state in young men

PURPOSE

Isomaltulose is a low glycemic and insulinaemic carbohydrate available as a constituent in sports drink. However, it remains unclear whether postexercise rehydration achieved by isomaltulose drink ingestion alone differs as compared to other carbohydrates.

METHODS

Thirteen young men performed intermittent exercise in the heat (35 °C and relative humidity 40%) to induce a state of hypohydration as defined by a 2% loss in body mass. Thereafter, participants were rehydrated by ingesting drinks equal to the volume of body mass loss with either a mixture of 3.25% glucose and 3.25% fructose, 6.5% sucrose (SUC), or 6.5% isomaltulose (ISO) within the first 30 min of a 3-h recovery. The change in plasma volume (ΔPV) from pre-exercise baseline, blood glucose, and plasma insulin concentration were assessed every 30-min.

RESULTS

ΔPV was lower in ISO as compared to SUC until 90 min of the recovery (all P ≤ 0.038) with no difference thereafter (all P ≥ 0.391). The ΔPV were paralleled by concomitant changes in blood glucose levels that were greater in ISO as compared to other drinks after 90 min of the recovery (all P ≤ 0.035). Plasma insulin secretion, which potentially enhances renal sodium reabsorption and fluid retention, did not differ between the trials (interaction, P = 0.653). ISO induced a greater net fluid volume retention as compared to SUC (P = 0.010).

CONCLUSION

We showed that rehydration with an isomaltulose drink following exercise-heat stress induces comparable recovery of PV and a greater net fluid retention as compared to other drinks, albeit this response is delayed. The delayed water transport along with glucose absorption may modulate this response. This trial was registered in 25th Sep 2019 at https://www.umin.ac.jp/ as UMIN000038099. (249/250).

Temperature Is Sufficient to Condition a Flavor Preference for a Cold-Paired Solution in Rats

Increasing evidence suggests that stimulus temperature modifies taste signaling. However, understanding how temperature modifies taste-driven behavior is difficult to separate as we must first understand how temperature alone modifies behavior. Previous work has suggested that cold water is more rewarding and "satiating" than warm water, and water above orolingual temperature is avoided in brief-access testing. We explored the strength of cold water preference and warm water avoidance by asking: (1) if cold temperature alone was sufficient to condition a flavor preference and (2) if avoidance of warm stimuli is driven by novelty. We addressed these questions using custom-designed equipment that allows us to monitor and maintain solution temperatures. We conducted two-bottle preference tests, after pairing Kool-Aid flavors with 10 or 40 °C. Rats preferred the flavor paired with cold temperature, both while it was cold and for 1 day while solutions were presented at 22 °C. We then examined the role of novelty in avoidance of 40 °C. Rats were maintained on 10, 22, or 40 °C water in their home cage to increase familiarity with the temperatures. Rats were then subject to a series of brief-access taste tests to water or sucrose at 10 to 40 °C. Rats that had 40 °C experience licked more to 40 °C water, but not sucrose, during brief-access testing. In a series of two-bottle preference tests, rats maintained on 40 °C water had a decreased preference for 10 °C water when paired opposite 40 °C water. Together, these data contribute to our understanding of orosensory-driven behavior with water at different temperatures.

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

There has been substantial progress in the knowledge of exercise and type 1 diabetes, with the development of guidelines for optimal glucose management. In addition, an increasing number of people living with type 1 diabetes are pushing their physical limits to compete at the highest level of sport. However, the post-exercise recovery routine, particularly with a focus on sporting performance, has received little attention within the scientific literature, with most of the focus being placed on insulin or nutritional adaptations to manage glycaemia before and during the exercise bout. The post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the rest of the day and overnight. The absence of clear guidance for the post-exercise period means that people with type 1 diabetes should either develop their own recovery strategies on the basis of individual trial and error, or adhere to guidelines that have been developed for people without diabetes. This Review provides an up-to-date consensus on post-exercise recovery and glucose management for individuals living with type 1 diabetes. We aim to: (1) outline the principles and time course of post-exercise recovery, highlighting the implications and challenges for endurance athletes living with type 1 diabetes; (2) provide an overview of potential strategies for post-exercise recovery that could be used by athletes with type 1 diabetes to optimise recovery and adaptation, alongside improved glycaemic monitoring and management; and (3) highlight the potential for technology to ease the burden of managing glycaemia in the post-exercise recovery period.

Personalized hydratation status in endurance and ultra-endurance: A review

This review aims to investigate the physiological mechanisms that underlie the hydro-electrolyte balance of the human body and the most appropriate hydration modalities for individuals involved in physical and sports activities, with a focus on ultra-endurance events. The role of effective hydration in achieving optimal sports performance is also investigated. An adequate pre-hydration is essential to perform physical and sporting activity in a condition of eu-hydration and to mantain physiologic levels of plasma electrolyte. To achieve these goals, athletes need to consume adequate drinks together with consuming meals and fluids, in order to provide an adequate absorption of the ingested fluids and the expulsion of those in excess through diuresis. Therefore, there are important differences between individuals in terms of sweating rates, the amount of electrolytes loss and the specific request of the discipline practiced and the sporting event to pursue.

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

Milk permeate is an electrolyte-rich, protein- and fat-free liquid with a similar carbohydrate and mineral content to that of milk. Its hydration efficacy has not been examined. The beverage hydration index (BHI) has been used to compare various beverages to water in terms of post-ingestion fluid balance and retention. Our purpose was to compare the BHI (and related physiological responses) of a novel milk permeate solution (MPS) to that of water and a traditional carbohydrate–electrolyte solution (CES). Over three visits, 12 young subjects consumed 1 L of water, CES, or MPS. Urine samples were collected immediately post-ingestion and at 60, 120, 180, and 240 min. BHI was calculated by dividing cumulative urine output after water consumption by cumulative urine output for each test beverage at each time point. The BHI for MPS was significantly higher at all time points compared to water (all p < 0.001) and CES (all p ≤ 0.01) but did not differ between CES and water at any time point. Drinking 1 L of MPS resulted in decreased cumulative urine output across the subsequent 4 h compared to water and CES, suggesting that a beverage containing milk permeate is superior to water and a traditional CES at sustaining positive fluid balance post-ingestion.

Fluid Intake Habits in Type 1 Diabetes Individuals during Typical Training Bouts

BACKGROUND/AIMS

Hyperglycemia may influence the hydration status in diabetic individuals. During exercise, type 1 diabetes mellitus (T1DM) individuals may be challenged by a higher risk of dehydration due to a combination of fluid losses from sweat and increased urine output via glycosuria. So far, no study has characterised spontaneous fluid intake in T1DM individuals during active trainings.

METHODS

A validated questionnaire was used to assess T1DM participants' diabetes therapy, sports characteristics and fluid intake during training; results were then compared to an age- and sport-matched sample of non-diabetic individuals.

RESULTS

Ninety individuals completed the survey (n = 45 T1DM individuals, n = 45 matched controls). A proportion of T1DM -individuals reported blood glucose levels greater than 10.0 mmol at both the start (28.9%) and end (24.4%) of the exercise. The mean self-reported fluid intake was greater in T1DM (0.60 ± 0.47 L·h-1) compared to that of the control (0.37 ± 0.28 L·h-1, p < 0.05). In spite of drinking fluid volumes in line with international guidelines, 84.4% of those with T1DM reported that they were still feeling thirsty at the end of their training session.

CONCLUSIONS

T1DM individuals self-report spontaneously consuming fluid adequate volumes suggested by sport nutrition guidelines for non-diabetic athletes. Discrepancies in the T1DM subjectively reported feelings of thirst suggest that more education on hydration during exercise is needed for this population to adequately compensate for elevated blood glucose levels. It remains to be established whether fluid volumes suggested for healthy athletes are adequate for maintaining euhydration in T1DM patients due to their altered diuresis.

Body mass changes during training in elite rugby union: Is a single test of hydration indices reliable?

There is limited research studying fluid and electrolyte balance in rugby union players, and a paucity of information regarding the test-retest reliability. This study describes the fluid balance of elite rugby union players across multiple squads and the reliability of fluid balance measures between two equivalent training sessions. Sixty-one elite rugby players completed a single fluid balance testing session during a game simulation training session. A subsample of 21 players completed a second fluid balance testing session during an equivalent training session. Players were weighed in minimal clothing before and after each training session. Each player was provided with their own drinks which were weighed before and after each training session. More players gained body weight (9 (14.8%)) during training than lost greater than 2% of their initial body mass (1 (1.6%)). Pre-training body mass and rate of fluid loss were significantly associated (r = 0.318, p = .013). There was a significant correlation between rate of fluid loss in sessions 1 (1.74 ± 0.32 L h^-1) and 2 (1.10 ± 0.31 L. h^-1), (r = 0.470, p = .032). This could be useful for nutritionists working with rugby squads to identify players with high sweat losses.

Neural circuits underlying thirst and fluid homeostasis

Thirst motivates animals to find and consume water. More than 40 years ago, a set of interconnected brain structures known as the lamina terminalis was shown to govern thirst. However, owing to the anatomical complexity of these brain regions, the structure and dynamics of their underlying neural circuitry have remained obscure. Recently, the emergence of new tools for neural recording and manipulation has reinvigorated the study of this circuit and prompted re-examination of longstanding questions about the neural origins of thirst. Here, we review these advances, discuss what they teach us about the control of drinking behaviour and outline the key questions that remain unanswered.

Should Workers Avoid Consumption of Chilled Fluids in a Hot and Humid Climate?

Despite provision of drinking water as the most common method of occupational heat stress prevention, there remains confusion in hydration messaging to workers. During work site interactions in a hot and humid climate, workers commonly report being informed to consume tepid fluids to accelerate rehydration. When questioned on the evidence supporting such advice, workers typically cite that fluid absorption is delayed by ingestion of chilled beverages. Presumably, delayed absorption would be a product of fluid delivery from the gut to the intestines, otherwise known as gastric emptying. Regulation of gastric emptying is multifactorial, with gastric volume and beverage energy density the primary factors. If gastric emptying is temperature dependent, the impact of cooling is modest in both magnitude and duration (≤ 5 minutes) due to the warming of fluids upon ingestion, particularly where workers have elevated core temperature. Given that chilled beverages are most preferred by workers, and result in greater consumption than warm fluids during and following physical activity, the resultant increased consumption of chilled fluids would promote gastric emptying through superior gastric volume. Hence, advising workers to avoid cool/cold fluids during rehydration appears to be a misinterpretation of the research. More appropriate messaging to workers would include the thermal benefits of cool/cold fluid consumption in hot and humid conditions, thereby promoting autonomy to trial chilled beverages and determine personal preference. In doing so, temperature-based palatability would be maximized and increase the likelihood of workers maintaining or restoring hydration status during and after their work shift.

From Thirst to Satiety: The Anterior Mid-Cingulate Cortex and Right Posterior Insula Indicate Dynamic Changes in Incentive Value

The cingulate cortex and insula are among the neural structures whose activations have been modulated in functional imaging studies examining discrete states of thirst and drinking to satiation. Building upon these findings, the present study aimed to identify neural structures that change their pattern of activation elicited by water held in the mouth in relation to the internal body state, i.e., proportional to continuous water consumption. Accordingly, participants in a thirsty state were scanned while receiving increments of water until satiety was reached. As expected, fluid ingestion led to a clear decrease in self-reported thirst and the pleasantness ratings of the water ingested. Furthermore, linear decreases in the blood oxygenation level dependent (BOLD) response to water ingestion were observed in the anterior mid-cingulate cortex (aMCC) and right posterior insula as participants shifted towards the non-thirsty state. In addition, regions in the superior temporal gyrus (STG), supplementary motor area (SMA), superior parietal lobule (SPL), precuneus and calcarine sulcus also showed a linear decrease with increasing fluid consumption. Further analyses related single trial BOLD responses of associated regions to trial-by-trial ratings of thirst and pleasantness. Overall, the aMCC and posterior insula may be key sites of a neural network representing the motivation for drinking based on the dynamic integration of internal state and external stimuli.

Oral Cooling and Carbonation Increase the Perception of Drinking and Thirst Quenching in Thirsty Adults

Fluid ingestion is necessary for life, and thirst sensations are a prime motivator to drink. There is evidence of the influence of oropharyngeal stimulation on thirst and water intake in both animals and humans, but how those oral sensory cues impact thirst and ultimately the amount of liquid ingested is not well understood. We investigated which sensory trait(s) of a beverage influence the thirst quenching efficacy of ingested liquids and the perceived amount ingested. We deprived healthy individuals of liquid and food overnight (> 12 hours) to make them thirsty. After asking them to drink a fixed volume (400 mL) of an experimental beverage presenting one or two specific sensory traits, we determined the volume ingested of additional plain, 'still', room temperature water to assess their residual thirst and, by extension, the thirst-quenching properties of the experimental beverage. In a second study, participants were asked to drink the experimental beverages from an opaque container through a straw and estimate the volume ingested. We found that among several oro-sensory traits, the perceptions of coldness, induced either by cold water (thermally) or by l-menthol (chemically), and the feeling of oral carbonation, strongly enhance the thirst quenching properties of a beverage in water-deprived humans (additional water intake after the 400 ml experimental beverage was reduced by up to 50%). When blinded to the volume of liquid consumed, individual's estimation of ingested volume is increased (~22%) by perceived oral cold and carbonation, raising the idea that cold and perhaps CO2 induced-irritation sensations are included in how we normally encode water in the mouth and how we estimate the quantity of volume swallowed. These findings have implications for addressing inadequate hydration state in populations such as the elderly.

Infusing pleasure: Mood effects of the consumption of a single cup of tea

Tea has historically been associated with mood benefits. Nevertheless, few studies have empirically investigated mood changes after tea consumption. We explored immediate effects of a single cup of tea up to an hour post-consumption on self-reported valence, arousal, discrete emotions, and implicit measures of mood. In a parallel group design, 153 participants received a cup of tea or placebo tea, or a glass of water. Immediately (i.e. 5 min) after consumption, tea increased valence but reduced arousal, as compared to the placebo. There were no differences at later time points. Discrete emotions did not differ significantly between conditions, immediately or over time. Water consumption increased implicit positivity as compared to placebo. Finally, consumption of tea and water resulted in higher interest in activities overall and in specific activity types compared to placebo. The present study shows that effects of a single cup of tea may be limited to an immediate increase in pleasure and decrease in arousal, which can increase interest in activities. Differences between tea and water were not significant, while differences between water and placebo on implicit measures were unexpected. More servings over a longer time may be required to evoke tea's arousing effects and appropriate tea consumption settings may evoke more enduring valence effects.

The role of fluid temperature and form on endurance performance in the heat

Exercising in the heat often results in an excessive increase in body core temperature, which can be detrimental to health and endurance performance. Research in recent years has shifted toward the optimum temperature at which drinks should be ingested. The ingestion of cold drinks can reduce body core temperature before exercise but less so during exercise. Temperature of drinks does not seem to have an effect on the rate of gastric emptying and intestinal absorption. Manipulating the specific heat capacity of a solution can further induce a greater heat sink. Ingestion of ice slurry exploits the additional energy required to convert the solution from ice to water (enthalpy of fusion). Body core temperature is occasionally observed to be higher at the point of exhaustion with the ingestion of ice slurry. There is growing evidence to suggest that ingesting ice slurry is an effective and practical strategy to prevent excessive rise of body core temperature and improve endurance performance. This information is especially important when only a fixed amount of fluid is allowed to be carried, often seen in some ultra-endurance events and military operations. Future studies should evaluate the efficacy of ice slurry in various exercise and environmental conditions.

Optimal composition of fluid-replacement beverages

The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences.

The influence of ice slushy on voluntary contraction force following exercise-induced hyperthermia

This study aimed to investigate the effect of exercise-induced hyperthermia on central fatigue and force decline in exercised and nonexercised muscles and whether ingestion of ice slushy (ICE) ameliorates fatigue. Eight participants (5 males, 3 females) completed 45 s maximal voluntary isometric contractions (MVIC) with elbow flexors and knee extensors at baseline and following an exercise-induced rectal temperature (Trec) of 39.3 ± 0.2 °C. Percutaneous electrical muscle stimulation was superimposed at 15, 30 and 44 s during MVICs to assess muscle activation. To increase Trec to 39.3 °C, participants cycled at 60% maximum power output for 42 ± 11 min in 40 °C and 50% relative humidity. Immediately prior to each MVIC, participants consumed 50 g of ICE (-1 °C) or thermoneutral drink (38 °C, CON) made from 7.4% carbohydrate beverage. Participants consumed water (19 °C) during exercise to prevent hypohydration. Voluntary muscle force production and activation in both muscle groups were unchanged at Trec 39.3 °C with ICE (knee extensors: 209 ± 152 N) versus CON (knee extensors: 255 ± 157 N, p = 0.19). At Trec 39.3 °C, quadriceps mean force (232 ± 151 N) decreased versus baseline (302 ± 180 N, p < 0.001) and mean voluntary activation was also decreased (by 15% ± 11%, p < 0.001). Elbow flexor mean force decreased from 179 ± 67 N to 148 ± 65 N when Trec was increased to 39.3 °C (p < 0.001) but mean voluntary activation was not reduced at 39.3 °C (5% ± 25%, p = 0.79). After exercise-induced hyperthermia, ICE had no effect on voluntary activation or force production; however, both were reduced from baseline in the exercised muscle group. Peripheral fatigue was greater than the central component and limited the ability of an intervention designed to alter central fatigue.

Effects of rehydration fluid temperature and composition on body weight retention upon voluntary drinking following exercise-induced dehydration

The purpose of this study was to determine the effects of beverage temperature and composition on weight retention and fluid balance upon voluntary drinking following exercise induced-dehydration. Eight men who were not acclimated to heat participated in four randomly ordered testing sessions. In each session, the subjects ran on a treadmill in a chamber maintained at 37℃ without being supplied fluids until 2% body weight reduction was reached. After termination of exercise, they recovered for 90 min under ambient air conditions and received one of the following four test beverages: 10℃ water (10W), 10℃ sports drink (10S), 26℃ water (26W), and 26℃ sports drink (26S). They consumed the beverages ad libitum. The volume of beverage consumed and body weight were measured at 30, 60, and 90 min post-recovery. Blood samples were taken before and immediately after exercise as well as at the end of recovery in order to measure plasma parameters and electrolyte concentrations. We found that mean body weight decreased by 1.8-2.0% following exercise. No differences in mean arterial pressure, plasma volume, plasma osmolality, and blood electrolytes were observed among the conditions. Total beverage volumes consumed were 1,164 ± 388, 1,505 ± 614, 948 ± 297, and 1,239 ± 401 ml for 10W, 10S, 26W, and 26S respectively (P > 0.05). Weight retention at the end of recovery from dehydration was highest in 10S (1.3 ± 0.7 kg) compared to 10W (0.4 ± 0.5 kg), 26W (0.4 ± 0.4 kg), and (0.6 ± 0.4 kg) (P < 0.005). Based on these results, carbohydrate/electrolyte-containing beverages at cool temperature were the most favorable for consumption and weight retention compared to plain water and moderate temperature beverages.

Water restriction and fluid temperature alter preference for water and sucrose solutions

The role of diet temperature in ingestive behavior is poorly understood. We examined the importance of stimulus temperature and water-restriction state on the preference for and intake of water and sucrose. Using custom-designed equipment that allows us to monitor and maintain solution temperatures during testing (±0.1 °C), we conducted a series of 2-bottle preference tests (10 °C water vs. sucrose 10-40 °C) and brief access tests (10-40 °C water and sucrose). Water-restricted rats preferred cold water over any sucrose concentration (0.0-1.0 M) if the sucrose was 30 or 40 °C, whereas the same rats preferred sucrose at all concentrations and temperatures when unrestricted suggesting that the water-restriction state interacts with temperature preference. In a series of brief-access tests using a Davis Rig (MS-180), rats reduced licking to cold sucrose compared with 20 °C sucrose, suggesting that unlike water, cold temperature reduced the palatability of sucrose.

Thirst-drinking, hunger-eating; tight coupling?

Although thirst and hunger have historically motivated drinking and feeding, respectively, the high and increasing consumption of energy-yielding beverages and energy-diluted foods may have degraded the predictive value of these sensations on ingestive behavior. Our within subject (ie, multiple responses from the same individuals), observational (ie, free-living, with no intervention) study explored the relationships between thirst, hunger, eating, and drinking patterns in 50 weight-stable adults (39 women and 11 men aged 30+/-11 years with body mass index 26.3+/-5.9). Twenty-four-hour dietary recalls were obtained for a consecutive 7-day period. Appetite ratings were recorded hourly, over the same time period, and correlated with hourly energy and fluid intake from food and beverages. Thirst ratings were not correlated with drinking (r=0.03) or energy intake (r=0.08) during the same hour over the 7-day period. Hunger ratings were significantly, albeit moderately, correlated with energy intake (r=0.30) (P<0.05), but not with drinking (r=0.04). On average, 75% of total fluid intake was consumed during periprandial events. Further, energy-yielding beverages were the main contributor to fluid intake during both periprandial and drink-only events. These data fail to reveal associations between either thirst or hunger and ingestion of energy-yielding beverages, or strong associations between hunger and eating or thirst and drinking. These data raise questions about the predictive power of appetitive sensations for ingestive behavior.

Relationships between human thirst, hunger, drinking, and feeding

There is a widely held view that hunger prompts feeding to ensure energy needs are met, while thirst cues drinking to address hydration requirements. However, recent changes in the nature of the food supply and eating patterns have raised questions about the functionality of these relationships with respect to maintaining energy balance. The increasing consumption of energy-yielding beverages and foods with diluted energy density, through the use of ingredients such as high-intensity sweeteners and fat replacers, poses new challenges to presumed homeostatic energy regulatory mechanisms. This review draws on findings from a recent observational study and other published evidence to explore whether shifts of food composition and use patterns may be disrupting relationships between thirst, hunger, drinking, and eating, resulting in positive energy balance (e.g., drinking low satiety, energy-yielding beverages in response to hunger). The observational study entailed collecting hourly appetitive ratings and dietary recalls from 50 adults for seven consecutive days. These data reveal a clear bimodal daily hunger pattern, whereas thirst is stronger and more stable throughout the day. Further, approximately 75% of fluid intake occurs peri-prandially, with the majority derived from energy-yielding beverages. While there is published evidence that drinking is responsive to feeding, support for the view that drinking is the more tightly regulated behavior is stronger. Our data indicates that, due to a number of plausible factors, neither absolute values nor changes of hunger or thirst are strong predictors of energy intake. However, it is proposed that stable, high thirst facilitates drinking, and with the increased availability and use of energy-yielding beverages that have low satiety properties, can promote positive energy balance. There are marked individual differences in mean daily hunger and thirst ratings with unknown implications for energy balance.

Voluntary drinking and hydration in non-acclimatized girls exercising in the heat

The intent of this study was to assess the influence of drink flavor and composition on voluntary drinking and hydration status in girls exercising intermittently in the heat (35 +/- 1 degrees C, 45-50% relative humidity). Twelve physically active, nonacclimatized girls (9-12 years) performed three 3 h identical sessions, each consisting of four 20 min cycling bouts at 50% (VO(2max)), separated by 25 min of rest. One of the three beverages (chilled to 8-10 degrees C) was assigned to each session: unflavored water (W), grape-flavored water (FW) and grape-flavored water plus 6% carbohydrate and 18 mmol l(-1) NaCl (CNa). Drinking was ad libitum. Body weight (BW), drink intake (DI), heart rate, rectal and skin temperatures, and perceptions of thirst and stomach fullness were monitored periodically. Total DI was 759, 940, 1,045 g in W, FW and CNa, respectively (P < 0.05 for CNa-W and FW-W). BW changes were -0.15, 0.16, and 0.45% in W, FW and CNa, respectively, but only the difference between CNa and W was significant (P < 0.05). Other physiological and perceptual variables were not different between trials. In conclusion, beverage flavoring regardless if its combination with carbohydrate and NaCl, mildly enhanced voluntary drinking in young non-acclimatized girls. In contrast to previous research in young boys, euhydration was maintained in the girls by an adequate intake of unflavored water.

Ambient-temperature beverages are consumed at a rate similar to chilled water in heat-exposed workers

Palatability of beverages has been shown to influence drinking patterns and hydration. Cool beverages are known to enhance palatability; however, situations exist in which cooling is not possible. The purpose of this study was to determine the palatability of a variety of flavors of ambient temperature beverages. Ten healthy males performed two work trials in a temperature-controlled environment (WBGT = 30 degrees C; wet = 25 degrees C, dry = 40 degrees C, globe = 41 degrees C). In one trial, the subjects had only chilled water to drink. In the second trial the subjects drank their choice (any or all) of five ambient temperature beverages (water, fruit punch, lemon-lime, orange, and cola). Repeated measures ANOVA showed no difference in absolute or relative fluid consumption between the two trials (chilled = 1730 +/- 316 mL and 21 +/- 5 mL/kg; ambient [all five beverages combined] = 1510 +/- 219 mL and 19 +/- 4 mL/kg). There was no difference in the rate of fluid consumption between the two trials (608 +/- 88 mL/30 min and 674 +/- 82 mL/30 min, p > 0.05). Additionally, when combining all ambient-temperature, flavored beverages, consumption was significantly greater than that of ambient temperature water (1245 +/- 206 vs. 255 +/- 86 mL, p < 0.05). These findings demonstrate that providing ambient temperature beverages in a hot condition results in fluid consumption values similar to chilled water. These findings are relevant to industry in that there may be times when workers are at risk for heat-related illness due to dehydration and chilled beverages are not available. By providing flavored beverages, fluid consumption may be maintained and degree of heat-illness may be lessened.

Oral hydration, parotid salivation and the perceived pleasantness of small water volumes

Previous studies have suggested that the preference for drinking cold water is increased when the drinker has a dry mouth. In a first experiment, we investigated whether a positive shift in preference would occur for small water volumes (0.75 ml and 1.5 ml) at 8, 16 or 25 degrees C, delivered into a mouth that had been dried using a warmed airflow, versus a normally hydrated mouth. Subjects rated the perceived wetness (or dryness) of their mouth, and the perceived pleasantness (or unpleasantness) of the water samples, using a labeled magnitude scale. Cooler water samples were preferred, and consistent with previous research, this preference was slightly enhanced when the subject's mouth was dried. The coldest water sample led to significantly wetter mouthfeel than the other two less cold samples, consistent with the possibility that the coldest water increased the rate of salivation. However, a second experiment found that although the rate of parotid salivation was increased if the mouth had been dried using a warm airflow, the different water temperatures did not induce different rates of parotid salivation. This indicates that enhanced preference for cold water when the mouth is dry is not invariably based in the reward gained from mouth rewetting via increased parotid saliva flow.

Drink temperature influences fluid intake and endurance capacity in men during exercise in a hot, dry environment

The effect of different drink temperatures on the perception of exertion and exercise endurance has not been extensively investigated. Consequently, the purpose of the present study was to examine the effect of drink temperature on fluid intake and endurance during cycling in the heat. Eight healthy, non-acclimated males (26 +/- 7 years; maximum oxygen uptake, 54 +/- 5 ml kg(-1) min(-1); mean +/- S.D.) cycled to exhaustion at 34 degrees C and at 65% of their peak aerobic power, consuming a drink at either 19 degrees C (CON) or 4 degrees C (COLD). Six of the eight subjects cycled for longer during COLD, with exhaustion occurring at 62 +/- 4 min, compared to 55 +/- 4 min for CON (P < 0.05; mean +/- S.E.M.). Subjects consumed significantly more fluid during COLD compared to CON (1.3 +/- 0.3 l h(-1) compared to 1.0 +/- 0.2 l h(-1); P < 0.05). Heart rate tended to be lower by approximately 5 beats min(-1) during COLD, and rectal temperature during the second half of the exercise period was approximately 0.25 degrees C lower during the COLD trial; however, these trends were not significant (P = 0.08 and P = 0.07, respectively). No differences were observed between trials for ventilation, concentrations of prolactin, glucose and lactate or perceived exertion. It is concluded that a drink at 4 degrees C during exercise in the heat enhances fluid consumption and improves endurance by acting as a heat sink, attenuating the rise in body temperature and therefore reducing the effects of heat stress.

Hydration status in college football players during consecutive days of twice-a-day preseason practices

BACKGROUND

Football players lose 3.5 to 5 kg of body weight during preseason practices because of heavy sweating. This fluid may be difficult to replace when practices occur 2 times per day on consecutive days.

HYPOTHESIS

Football players are hypohydrated during twice-a-day preseason training in a hot, humid environment.

STUDY DESIGN

Descriptive laboratory study.

METHODS

In 10 college football players, body weight was measured, and blood and urine samples were obtained before and after practices on days 2 through 8 of preseason training. Baseline samples were obtained when subjects were euhydrated. Blood samples were used to calculate plasma volume changes. Urine samples were analyzed for specific gravity, sodium, and potassium. Sweat rate was calculated. Core temperature was monitored during half- and full-padded practices.

RESULTS

Mean wet bulb temperatures were 23.3 degrees C during morning practices and 23.7 degrees C during afternoon practices. Plasma volume was below baseline on day 2 and expanded by day 6. Urine specific gravity was higher than baseline for 12 of 20 measurements over the 8 days. It was 1.0175 +/- 0.006 at baseline but subsequently ranged from 1.0214 +/- 0.007 to 1.0321 +/- 0.004. Mean daily urine sodium dropped from baseline to day 2 (194 +/- 43 vs 43 +/- 38 mmol x L-1), remaining lower on days 3, 4, and 6 (40 +/- 39, 39 +/- 39, and 68 +/- 40 mmol x L-1, respectively). Urine potassium was lower on days 6 and 8 compared with baseline and day 3. Body weight was below baseline before and after both daily practices. Core temperature was higher in full pads; sweat rate and body weight loss were not different between half and full pads.

CONCLUSION

Body weight, plasma volume, urine specific gravity, and urine sodium indicate that football players become dehydrated by day 2 of preseason training. Urine sodium increased to near baseline by day 8; urine specific gravity was elevated.

CLINICAL RELEVANCE

Football players struggle to maintain euhydration during preseason twice-a-day sessions.

Rehydration fluid temperature affects voluntary drinking in horses dehydrated by furosemide administration and endurance exercise

To determine whether temperature of rehydration fluid influences voluntary rehydration by horses, six 2-3-year-old horses were dehydrated (4-5% body weight loss) by a combination of furosemide administration and 30 km of treadmill exercise. For the initial 5 min following exercise, horses were offered a 0.9% NaCl solution at 10, 20, or 30 degrees C. Subsequently, after washing and cooling out, voluntary intake of water at 10, 20, or 30 degrees C from 20 to 60 min after exercise was measured. Fluid intake (FI) during the first 5 min of recovery was 9.8+/-2.5,12.3+/-2.1 and 9.7+/-2.0L (p>0.05) for saline at 10, 20, and 30 degrees C, respectively. Although not a significant finding, horses offered 0.9% NaCl at 20 degrees C tended to take fewer (p=0.07), longer drinks than when saline at either 10 or 30 degrees C was offered. Between 20 and 60 min of recovery, intake of water at 20 degrees C (7.7+/-0.8L) and 30 degrees C (6.6+/-1.2L) was greater (p<0.05) than that at 10 degrees C (4.9+/-0.5L). Thus, total FI was 14.7+/-2.5,19.9+/-2.5, and 16.3+/-2.4L for rehydration fluids at 10, 20, and 30 degrees C, respectively (p<0.05, value for 20 degrees C water greater than that for 10 degrees C water). Although the amount of metabolic heat transferred to the initial saline drink was correlated with the decrease in core temperature during the initial 5 min of recovery, heat transfer to ingested fluid was most likely responsible for the dissipation of, at most, 5% of the heat generated during endurance exercise. In conclusion, following exercise these dehydrated-normothermic horses voluntary drank the greatest amount of fluid at near ambient (20 degrees C) temperature. Although not determined in this study, greater satiation of thirst by oropharyngeal cooling may have contributed to lesser intake of colder (10 degrees C) fluid.

The effect of oral temperature on the temperature perception of liquids and semisolids in the mouth

This work examined the influence of oral temperature on oral perception of temperature in liquids and semisolids. A panel of 20 adults assessed the temperature of water, custard dessert and mayonnaise. Oral temperatures were manipulated by 5-s mouth rinses of 10, 35 and 55 degrees C performed prior to assessments, which resulted in oral temperatures of 27, 35 and 43 degrees C, respectively. The products were evaluated at 10, 22 and 35 degrees C. Results show that subjects were able to differentiate between the product temperatures. A large effect of type of product was seen on perceived temperature, where water was, overall, perceived as significantly colder than custard dessert and mayonnaise. The range of perceived thermal ratings was widest for custard dessert, followed by water and mayonnaise. This might be due to differences in composition and structure of the products. Even though oral temperature was varied considerably in the present study, this did not exert large effects on perceived temperature.

Effects of mouth dryness on drinking behavior and beverage acceptability

In humans, the association between mouth dryness and thirst has been examined in a variety of contexts. Typically, drinking behavior produces a concomitant reduction in unpleasant dry mouth sensations. Evidence is reviewed for a mechanism that influences the termination of drinking behavior by metering this change. Drinking behavior causes a progressive increase in parotid saliva flow. Thus, one possibility is that satiety results from a decrease in the reward associated with mouth wetting during a drinking episode. Beverages can differ in their satiating ability. This variability may be related to their mouth-wetting characteristic, and may be reflected in a shift in their acceptability when the mouth becomes dry. Physically drying the mouth appears to increase the acceptability of beverages that are either cold or acidic. It may be significant that two important determinants of mouth wetting are temperature and acidity. Cold or acidic beverages are also likely to be regarded as 'thirst-quenching.' Thus, shifts in acceptability, 'thirst quenching' and satiety may all be related to the mouth-wetting properties of a beverage. The extent to which this coincidence is meaningful warrants further investigation. However, if a common underlying process exists, then this may help to elucidate reasons for voluntary dehydration and aberrant drinking behavior in the elderly.

Special issues and concerns for the high school- and college-aged athletes

Increasing numbers of high school- and college-aged students are participating in sports. As sport participation and intensity increases, the frequency of associated heat related illnesses and acute and chronic overuse injuries will continue to become more prevalent. The sports medicine physician plays an essential role not only in the practice and treatment of injuries but also in educating athletes about safe and healthy exercise habits that will provide life long benefits.

The effectiveness of commercially available sports drinks

The purpose of this review is to evaluate the effectiveness of commercially available sports drinks by answering the questions: (i) will consuming a sports drink be beneficial to performance? and (ii) do different sports drinks vary in their effectiveness? To answer these questions we have considered the composition of commercially available sports drinks, examined the rationale for using them, and critically reviewed the vast number of studies that have investigated the effectiveness of sports drinks on performance. The focus is on the drinks that contain low carbohydrate concentrations (<10%) and are marketed for general consumption before and during exercise rather than those with carbohydrate concentrations >10%, which are intended for carbohydrate loading. Our conclusions are 3-fold. First, because of variations in drink composition and research design, much of the sports drinks research from the past cannot be applied directly to the effectiveness of currently available sports drinks. Secondly, in studies where a practical protocol has been used along with a currently available sports beverage, there is evidence to suggest that consuming a sports drinks will improve performance compared with consuming a placebo beverage. Finally, there is little evidence that any one sports drink is superior to any of the other beverages on the market.

Effects of temperature and volume on measures of mouth dryness, thirst and stomach fullness in males and females

The immediate post-ingestive effects of temperature on thirst reduction were explored. Thirst was assessed by both ratings and a volume selection task. Supplementary ratings assessed mouth dryness and stomach fullness. All measures were taken before and 0, 2.5 and 5 min after drinking one of four water samples (150 ml/5 degrees C, 400 ml/5 degrees C, 150 ml/22 degrees C or 400 ml/22 degrees C). After 2.5 min, the cold sample produced greater reductions than the warmer sample in (i) the thirst ratings of males who received 400-ml samples, and (ii) the volume selections of females who received 150-ml samples. It is proposed that temperature influenced thirst reduction because of its differential effects on the post-ingestive state of the mouth.

Mouth-state dependent changes in the judged pleasantness of water at different temperatures

Dehydration increases the pleasantness of cold (0 degrees C) water (Boulze et al., 1983, Physiol. Behav. 30:97-102, 1983). The hypothesis that the mouth dryness induced by dehydration mediates this hedonic shift was investigated. Hydrated assessors (n = 16) judged 3 degrees C water as more pleasant after artificial mouth drying than did controls (n = 16). Mouth drying failed to influence similar judgements of water 13 degrees C, 23 degrees C, and 33 degrees C. We propose that preference shifts depend on temperature because cold water offers more rewarding relief from the sensations resulting from mouth dryness. Measures on saliva production were consistent with this proposal. Assessors swilled with water (3 degrees C, 13 degrees C, 23 degrees C, and 33 degrees C) for 5 s and then emptied their mouths. Measures of subsequent saliva flow confirmed that cold (3 degrees C) water induces an elevated rate of saliva flow and consequently leaves the mouth in a wetter state.

Effects of oral and intravenous rehydration on ratings of perceived exertion and thirst

The purpose of this investigation was to compare the effects of oral and intravenous saline rehydration on differentiated ratings of perceived exertion (RPE) and thirst. Eight men underwent three randomly assigned rehydration treatments following a 2- to 4-h exercise-induced dehydration bout to reduce body weight by 4%. Treatments included 0.45% saline infusion (i.v.), 0.45% saline oral ingestion (ORAL), and no fluid (NF). Following rehydration and rest (2 h total), subjects walked at 50% VO2max for 90 min at 36 degrees C (EX). Central RPE during ORAL was lower (P < 0.05) than i.v. and NF throughout EX. Local RPE during NF was higher (P < 0.05) than i.v. and ORAL at minutes 20 and 40 of EX and overall RPE during NF was higher (P < 0.05) than ORAL at minutes 20 and 40 of EX. Significant correlations were found between overall RPE and mean skin temperature for i.v. (r = 0.72) and NF (r = 0.75), and between overall RPE and thirst ratings for i.v. (r = 0.70). Thirst ratings were not different among trials at postdehydration. Following rehydration, thirst was higher (P < 0.05) during NF than i.v. and ORAL and lower (P < 0.05) during ORAL than i.v. at all subsequent time points. Results suggest that oral rehydration is likely to elicit lower RPE and thirst ratings compared with intravenous rehydration.

Water and electrolyte replenishment in the exercising child

This article reviews studies, mostly from the authors' laboratory, on children's sweating rates and composition, voluntary drinking patterns during prolonged exercise in the heat, taste perception of beverages, and the importance of fluid flavor and composition in preventing voluntary dehydration. Subjects were children, exposed for 90 to 180 min to intermittent bouts of cycling (45-50% maximal O2 uptake) in a climatic chamber (mostly at 35 degrees C, 40-50% relative humidity). There were five main findings: When given unflavored water ad libitum, children dehydrated progressively and their core temperature increased faster than in adults. When offered drinks with various flavors, children preferred grape to other flavors. When given grape-flavored water during intermittent exercise in the heat, children voluntarily drank 44.5% more than with unflavored water. When given grape-flavored carbohydrate-electrolyte solution, they voluntarily drank 91% more than with unflavored water. Finally, such consumption of carbohydrate-electrolyte solution was sufficient to prevent voluntary dehydration during 180-min intermittent exercise in the heat.

American College of Sports Medicine position stand. Exercise and fluid replacement

It is the position of the American College of Sports Medicine that adequate fluid replacement helps maintain hydration and, therefore, promotes the health, safety, and optimal physical performance of individuals participating in regular physical activity. This position statement is based on a comprehensive review and interpretation of scientific literature concerning the influence of fluid replacement on exercise performance and the risk of thermal injury associated with dehydration and hyperthermia. Based on available evidence, the American College of Sports Medicine makes the following general recommendations on the amount and composition of fluid that should be ingested in preparation for, during, and after exercise or athletic competition: 1) It is recommended that individuals consume a nutritionally balanced diet and drink adequate fluids during the 24-hr period before an event, especially during the period that includes the meal prior to exercise, to promote proper hydration before exercise or competition. 2) It is recommended that individuals drink about 500 ml (about 17 ounces) of fluid about 2 h before exercise to promote adequate hydration and allow time for excretion of excess ingested water. 3) During exercise, athletes should start drinking early and at regular intervals in an attempt to consume fluids at a rate sufficient to replace all the water lost through sweating (i.e., body weight loss), or consume the maximal amount that can be tolerated. 4) It is recommended that ingested fluids be cooler than ambient temperature [between 15 degrees and 22 degrees C (59 degrees and 72 degrees F])] and flavored to enhance palatability and promote fluid replacement. Fluids should be readily available and served in containers that allow adequate volumes to be ingested with ease and with minimal interruption of exercise. 5) Addition of proper amounts of carbohydrates and/or electrolytes to a fluid replacement solution is recommended for exercise events of duration greater than 1 h since it does not significantly impair water delivery to the body and may enhance performance. During exercise lasting less than 1 h, there is little evidence of physiological or physical performance differences between consuming a carbohydrate-electrolyte drink and plain water. 6) During intense exercise lasting longer than 1 h, it is recommended that carbohydrates be ingested at a rate of 30-60 g.h(-1) to maintain oxidation of carbohydrates and delay fatigue. This rate of carbohydrate intake can be achieved without compromising fluid delivery by drinking 600-1200 ml.h(-1) of solutions containing 4%-8% carbohydrates (g.100 ml(-1)). The carbohydrates can be sugars (glucose or sucrose) or starch (e.g., maltodextrin). 7) Inclusion of sodium (0.5-0.7 g.1(-1) of water) in the rehydration solution ingested during exercise lasting longer than 1 h is recommended since it may be advantageous in enhancing palatability, promoting fluid retention, and possibly preventing hyponatremia in certain individuals who drink excessive quantities of fluid. There is little physiological basis for the presence of sodium in n oral rehydration solution for enhancing intestinal water absorption as long as sodium is sufficiently available from the previous meal.

Hypohydration during exercise in children: effect on thirst, drink preferences, and rehydration

This study examined changes in children's thirst and drink preferences during exercise-induced hypohydration and their spontaneous rehydration during a 30-min recovery. Twenty-four 9- to 13-year-old children (14 females, 10 males) participated in four intermittent 90-min cycling sessions in the heat (35 degrees C, 20% relative humidity); the sessions differed in the drinks the children were sampling (apple, orange, water, and grape). Thirst and drink preferences were assessed (analog and category scales) while children dehydrated up to about 0.76% of their initial body weight. During 90 min dehydration, there was an increase in thirst intensity for all drinks. The grape was the preferable drink throughout the dehydration phase, but its desirability did not increase as much as the desirability of the orange, apple, and water drinks. During the 30-min recovery, most subjects rehydrated spontaneously, exceeding baseline levels by 0.76 +/- 0.15% (M +/- SEM) for grape, 0.40 +/- 0.15 for apple, 0.71 +/- 0.18 for orange, and 0.48 +/- 0.16 for water. Although full rehydration was achieved with all drinks, the magnitude of rehydration was statistically greater with grape and orange than water and apple (p < .05). It was concluded that mild hypohydration during exercise increased children's thirst and drink desirability. In general, spontaneous overshoot of fluid consumption occurred during recovery.

Effects of temperature and mode of presentation of juice on hunger, thirst and food intake in humans

Foods differ in their satiating effects; temperature and mode of presentation may be factors important for these differences. We tested the effects of these two variables in normal weight, non-dieting males and females using vegetable juice. The juice was offered as a preload, with females receiving 300 g and males receiving 400 g under conditions that systematically varied temperature (60-62 degrees C vs. 1 degrees C) and presentation (served in mug vs. bowl with spoon); a no-preload condition was also included. Each preload was followed within 5 min by a second course of grilled cheese sandwiches. In the males, intake was significantly lower after cold but not hot preloads in comparison to the no-preload condition; however, intakes following the hot and cold preloads did not differ significantly. Males also reported a significantly greater decline in thirst following the cold preloads. Temperature of the preloads did not affect food intake or thirst in the female subjects. Neither group was affected by the mode of presentation of the preloads. Further studies with other types of foods and drinks are needed to clarify whether temperature or mode of presentation can influence satiating efficiency.

Carbohydrate feeding and exercise: effect of beverage carbohydrate content

The purpose of this study was to determine the effect of ingesting fluids of varying carbohydrate content upon sensory response, physiologic function, and exercise performance during 1.25 h of intermittent cycling in a warm environment (Tdb = 33.4 degrees C). Twelve subjects (7 male, 5 female) completed four separate exercise sessions; each session consisted of three 20 min bouts of cycling at 65% VO2max, with each bout followed by 5 min rest. A timed cycling task (1200 pedal revolutions) completed each exercise session. Immediately prior to the first 20 min cycling bout and during each rest period, subjects consumed 2.5 ml.kg BW-1 of water placebo (WP), or solutions of 6%, 8%, or 10% sucrose with electrolytes (20 mmol.l-1 Na+, 3.2 mmol.l-1 K+). Beverages were administered in double blind, counterbalanced order. Mean (+/- SE) times for the 1200 cycling task differed significantly: WP = 13.62 +/- 0.33 min, *6% = 13.03 +/- 0.24 min, 8% = 13.30 +/- 0.25 min, 10% = 13.57 +/- 0.22 min (* = different from WP and 10%, P less than 0.05). Compared to WP, ingestion of the CHO beverages resulted in higher plasma glucose and insulin concentrations, and higher RER values during the final 20 min of exercise (P less than 0.05). Markers of physiologic function and sensory perception changed similarly throughout exercise; no differences were observed among subjects in response to beverage treatments for changes in plasma concentrations of lactate, sodium, potassium, for changes in plasma volume, plasma osmolality, rectal temperature, heart rate, oxygen uptake, rating of perceived exertion, or for indices of gastrointestinal distress, perceived thirst, and overall beverage acceptance.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of water temperature and flavoring on voluntary dehydration in men

Effects of water temperature and flavoring on fluid consumption and body weight losses were studied in fourteen unacclimatized men (21-33 years) during 6 hr of treadmill exercise (4.8 km.hr-1, 5% grade for 30 min.hr-1) in a hot environment. Subjects consumed each of four beverages (15 degrees C water, 40 degrees C water, 15 degrees C flavored water, and 40 degrees C flavored water) on four nonconsecutive days. We identified two groups of individuals by body weight (BW) loss during the cool water trial: drinkers (D) who lost less than 2% initial BW (0.80 +/- 0.15%) and reluctant drinkers (RD) who lost more than 2% (2.53 +/- 0.12%). Although sweat losses were not different between the two groups, D consumed 31% more cool water than RD and experienced 68% less BW loss. Compared to the warm water trial, 6 hr consumption of cool water was significantly increased in both D (59%) and RD (141%) and BW loss was dramatically reduced in both groups. Flavoring significantly enhanced warm water consumption and reduced BW loss in RD only. Reduced consumption of warm water increased rectal temperature, heart rate and plasma osmolality in both groups. The results of this study indicate that either flavoring or cooling warm water will enhance fluid intake and reduce body weight deficits in men reluctant to drink.

The effects of consuming carbohydrate-electrolyte beverages on gastric emptying and fluid absorption during and following exercise

A variety of beverages formulated to provide fluid, carbohydrates, and electrolytes during and following exercise are commercially available. Such 'sport drinks' commonly contain 4 to 8% carbohydrate (as glucose, fructose, sucrose or maltodextrins) and small amounts of electrolytes (most often sodium, potassium, and chloride). The efficacy of consuming such beverages has been questioned primarily because of concern that beverage carbohydrate content may inhibit gastric emptying rate and fluid absorption during exercise, thereby jeopardizing physiological homeostasis and impairing exercise performance. Gastric motor activity, and consequently gastric emptying rate, is governed by neural and humoral feedback provided by receptors found in the gastric musculature and proximal small intestine. Gastric emptying rate may be influenced by a variety of factors including, but not limited to, the caloric content, volume, osmolality, temperature, and pH of the ingested fluid, diurnal and interindividual variation, metabolic state (rest/exercise), and the ambient temperature. The caloric content of the ingested fluid appears to be the most important variable governing gastric emptying rate, providing a mean caloric efflux from the stomach of 2.0 to 2.5 kcal/min for ingested fluid volumes less than 400 ml. At rest, gastric emptying is inhibited by solutions containing calories in a manner independent of the nutrient source (i.e. carbohydrate, fat or protein). Consequently, plain water is known to empty from the stomachs of resting subjects at rates faster than solutions containing calories. Gastric emptying is increasingly inhibited as the caloric content of the ingested fluid increases. During moderate exercise (less than 75% VO2max), gastric emptying occurs at a rate similar to that during rest; more intense exercise appears to inhibit gastric emptying. When fluids are consumed at regular intervals throughout prolonged exercise (greater than 2 hours), postexercise aspiration of stomach contents reveals that solutions containing up to 10% carbohydrate empty at rates similar to plain water. There is ample physiological justification for the addition of glucose, fructose, sodium, potassium and chloride to fluid replacement beverages. Fluid absorption in the small intestine is stimulated by glucose and sodium (and to a lesser extent by fructose and other electrolytes). Glucose and sodium are absorbed via a common membrane carrier in the mucosal epithelium of the proximal small intestine. The potentiation of sodium uptake by glucose establishes an osmotic gradient for fluid absorption.(ABSTRACT TRUNCATED AT 400 WORDS)