The turnover of body water as an indicator of health

Physical activity and heat stress shape water needs in pregnant endurance athletes

Background and objectives

Pregnancy, heat stress, and physical activity (PA) are all known to independently increase human water requirements. We hypothesize that climate conditions and behavioral strategies interact to shape water needs in highly active pregnancies.

Methodology

We recruited 20 female endurance runners who were pregnant (8-16 weeks gestational age; n = 13) or planning to be pregnant (n = 7) for an observational, prospective cohort study. At three timepoints in the study (preconception, 8-16 weeks, and 32-35 weeks), we measured water turnover (WT) using the deuterium dilution and elimination technique, PA using ActiGraph wGT3X-BT accelerometers, and heat index (HI) using historical temperature and humidity data. We also compared athletes to nonathletes from a previously published study.

Results

Athletes maintained high WT from preconception through the end of pregnancy. PA was positively associated with WT among athletes for preconception and early pregnancy time periods but not for the third trimester. HI weakly moderated the relationship between PA and WT in predicting a more positive slope in hotter and more humid weather conditions. WT in athletes was higher than in nonathletes, but this difference attenuated during the third trimester, as nonathletes increased their WT.

Conclusions and implications

Athletes experience higher WT with greater levels of PA, and this relationship is somewhat stronger in higher HI conditions. With the threat of climate change expected to exacerbate extreme heat conditions, evidence-based, global policies are required for particularly vulnerable populations.

Total daily energy expenditure and elevated water turnover in a small-scale semi-nomadic pastoralist society from Northern Kenya

BACKGROUND

Pastoralists live in challenging environments, which may be accompanied by unique activity, energy, and water requirements.

AIM

Few studies have examined whether the demands of pastoralism contribute to differences in total energy expenditure (TEE) and water turnover (WT) compared to other lifestyles.

SUBJECTS AND METHODS

Accelerometer-derived physical activity, doubly labelled water-derived TEE and WT, and anthropometric data were collected for 34 semi-nomadic Daasanach adults from three northern Kenyan communities with different levels of pastoralist activity. Daasanach TEEs and WTs were compared to those of other small-scale and industrialised populations.

RESULTS

When modelled as a function of fat-free-mass, fat-mass, age, and sex, TEE did not differ between Daasanach communities. Daasanach TEE (1564-4172 kcal/day) was not significantly correlated with activity and 91% of TEEs were within the range expected for individuals from comparison populations. Mean WT did not differ between Daasanach communities; Daasanach absolute (7.54 litres/day men; 7.46 litres/day women), mass-adjusted, and TEE-adjusted WT was higher than most populations worldwide.

CONCLUSIONS

The similar mass-adjusted TEE of Daasanach and industrialised populations supports the hypothesis that habitual TEE is constrained, with physically demanding lifestyles necessitating trade-offs in energy allocation. Elevated WT in the absence of elevated TEE likely reflects a demanding active lifestyle in a hot, arid climate.

Functional Beverages in the 21st Century

Underlying the dawn of humanity was primarily the search for food and access to drinking water. Over the course of civilization, there has been a significant increase in drinking water quality. By the average of the nutritional standards, the daily water demand is 2.5 L (also including liquid products such as tea, coffee, or soup). However, it is worth noticing that the need is strictly individual for each person and depends on two major factors, namely, epidemiological (sex, age state of health, lifestyle, and diet) and environmental (humidity and air temperature). Currently, our diet is more and more often enriched with isotonic drinks, functional drinks, or drinks bearing the hallmarks of health-promoting products. As a result, manufacturing companies compete to present more interesting beverages with complex compositions. This article will discuss both the composition of functional beverages and their impact on health.

Personalized prediction of optimal water intake in adult population by blended use of machine learning and clinical data

Growing evidence suggests that sustained concentrated urine contributes to chronic metabolic and kidney diseases. Recent results indicate that a daily urinary concentration of 500 mOsm/kg reflects optimal hydration. This study aims at providing personalized advice for daily water intake considering personal intrinsic (age, sex, height, weight) and extrinsic (food and fluid intakes) characteristics to achieve a target urine osmolality (U_Osm) of 500 mOsm/kg using machine learning and optimization algorithms. Data from clinical trials on hydration (four randomized and three non-randomized trials) were analyzed. Several machine learning methods were tested to predict U_Osm. The predictive performance of the developed algorithm was evaluated against current dietary guidelines. Features linked to urine production and fluid consumption were listed among the most important features with relative importance values ranging from 0.10 to 0.95. XGBoost appeared the most performing approach (Mean Absolute Error (MAE) = 124.99) to predict U_Osm. The developed algorithm exhibited the highest overall correct classification rate (85.5%) versus that of dietary guidelines (77.8%). This machine learning application provides personalized advice for daily water intake to achieve optimal hydration and may be considered as a primary prevention tool to counteract the increased incidence of chronic metabolic and kidney diseases.

Contribution of Dietary Composition on Water Turnover Rates in Active and Sedentary Men

Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated with hypohydration. There is currently limited research investigating the interrelationship of fluid balance, dietary intake and activity level when considering body water turnover. Therefore, this study investigates whether dietary composition and energy expenditure influences body water turnover. In our methodology, thirty-eight males (19 sedentary and 19 physically active) had their total body water and water turnover measured via the isotopic tracer deuterium oxide. Simultaneous tracking of dietary intake (food and fluid) is carried out via dietary recall, and energy expenditure is estimated via accelerometery. Our results show that active participants display a higher energy expenditure, water intake, carbohydrate intake and fibre intake; however, there is no difference in sodium or alcohol intake between the two groups. Relative water turnover in the active group is significantly greater than the sedentary group (Mean Difference (MD) [95% CI] = 17.55 g·kg^-1·day^-1 [10.90, 24.19]; p = < 0.001; g[95% CI] = 1.70 [0.98, 2.48]). A penalised linear regression provides evidence that the fibre intake (p = 0.033), water intake (p = 0.008), and activity level (p = 0.063) predict participants' relative body water turnover (R²= 0.585). In conclusion, water turnover is faster in individuals undertaking regular exercise than in their sedentary counterparts, and is, in part, explained by the intake of water from fluid and high-moisture content foods. The nutrient analysis of the participant diets indicates that increased dietary fibre intake is also positively associated with water turnover rates. The water loss between groups also contributes to the differences observed in water turnover; this is partly related to differences in sweat output during increased energy expenditure from physical activity.

Improved recovery from skeletal muscle damage is largely unexplained by myofibrillar protein synthesis or inflammatory and regenerative gene expression pathways

The contribution of myofibrillar protein synthesis (MyoPS) to recovery from skeletal muscle damage in humans is unknown. Recreationally active men and women consumed a daily protein-polyphenol beverage targeted at increasing amino acid availability and reducing inflammation (PPB; n = 9), both known to affect MyoPS, or an isocaloric placebo (PLA; n = 9) during 168 h of recovery from 300 maximal unilateral eccentric contractions (EE). Muscle function was assessed daily. Muscle biopsies were collected for 24, 27, 36, 72, and 168 h for MyoPS measurements using ²H₂O and expression of 224 genes using RT-qPCR and pathway analysis. PPB improved recovery of muscle function, which was impaired for 5 days after EE in PLA (interaction P < 0.05). Acute postprandial MyoPS rates were unaffected by nutritional intervention (24-27 h). EE increased overnight (27-36 h) MyoPS versus the control leg (PLA: 33 ± 19%; PPB: 79 ± 25%; leg P < 0.01), and PPB tended to increase this further (interaction P = 0.06). Daily MyoPS rates were greater with PPB between 72 and 168 h after EE, albeit after function had recovered. Inflammatory and regenerative signaling pathways were dramatically upregulated and clustered after EE but were unaffected by nutritional intervention. These results suggest that accelerated recovery from EE is not explained by elevated MyoPS or suppression of inflammation.NEW & NOTEWORTHY The present study investigated the contribution of myofibrillar protein synthesis (MyoPS) and associated gene signaling to recovery from 300 muscle-damaging, eccentric contractions. Measured with ²H₂O, MyoPS rates were elevated during recovery and observed alongside expression of inflammatory and regenerative signaling pathways. A nutritional intervention accelerated recovery; however, MyoPS and gene signaling were unchanged compared with placebo. These data indicate that MyoPS and associated signaling do not explain accelerated recovery from muscle damage.

Anti-Hypochlorite, Antioxidant, and Catalytic Activity of Three Polyphenol-Rich Super-Foods Investigated with the Use of Coumarin-Based Sensors

The anti-hypochlorite activity of açaí (Euterpe oleracea Mart.), goji (Lycium barbarum L.) and schisandra (Schisandra chinensis) fruit extracts were assessed by determining the reactive chlorine species (RCS)-scavenging ability of these three "super-food" berries. In addition, the aqueous extracts obtained were employed as both the media and the catalyst in a green chemistry approach to the synthesis of a coumarin-based fluorescence turn-off sensor, which was then used for anti-hypochlorite activity testing. The aqueous extracts were also assessed for total phenolic content (TPC), using the Folin-Ciocalteu method, and the antioxidant activity using the ABTS^+• assay. Moreover, the main water-soluble polyphenolic constituents of the extracts were identified by the HPLC-PDA-ESI-MS technique. Among the extracts tested, açaí demonstrated the highest anti-hypochlorite and antioxidant activities, while the highest TPC value was found for the goji extract. All extracts demonstrated modest catalytic activity as Knoevenagel condensation catalysts.

Water turnover among human populations: Effects of environment and lifestyle

OBJECTIVES

To discuss the environmental and lifestyle determinants of water balance in humans and identify the gaps in current research regarding water use across populations.

METHODS

We investigated intraspecific variation in water turnover by comparing data derived from a large number of human populations measured using either dietary survey or isotope tracking. We also used published data from a broad sample of mammalian species to identify the interspecific relationship between body mass and water turnover.

RESULTS

Water facilitates nearly all physiological tasks and water turnover is strongly related to body size among mammals (r2=0.90). Within humans, however, the effect of body size is small. Instead, water intake and turnover vary with lifestyle and environmental conditions. Notably, despite living physically active lives in conditions that should increase water demands, the available measures of water intake and turnover among small-scale farming and pastoralist communities are broadly similar to those in less active, industrialized populations.

CONCLUSIONS

More work is required to better understand the environmental, behavioral, and cultural determinants of water turnover in humans living across a variety of ecosystems and lifestyles. The results of such work are made more vital by the climate crisis, which threatens the water security of millions around the globe.

Association between the content of intracellular and extracellular fluid and the amount of water intake among Chinese college students

BACKGROUND

Normal distribution of body fluid is important for maintaining health through the balance of water metabolism. Studies have shown that disease states and diuretics perturb the balance and then induce abnormal intracellular/extracellular fluid ratio. However, there are relatively few researches on the associations between water intakes and body fluid. The objective of this study was to explore the association between body fluid and water intake.

METHODS

A total of 159 young adults in Baoding, China were recruited in this cross-sectional survey and completeness of follow-up was 98.1%. A 7-day fluid specific diary was used to record total fluid intake (TFI). Water intake from foods (FWI) for 3 days was measured using the methods of weighting, duplicate portion method and laboratory analysis by researchers. Body fluid was measured using bioelectrical impedance analysis.

RESULTS

Total body water (TBW), intracellular fluid (ICF) and extracellular fluid (ECF) of participants were 32.8[28.0,39.2], 20.5[17.3,24.5] and 12.4[10.7,14.7], (kg). This represented 55.2 ± 6.2, 34.4 ± 4.0 and 20.8 ± 2.3 (%) of body weight (BW), respectively. ICF, ECF and TBW among male participants who drank more than or equal to adequate TFI was higher than those who drank less (Z = -1.985, p = 0.047; Z = -2.134, p = 0.033; Z = -2.053, p = 0.040). Among both males and females, the values of TBW/BW in participants whose TWI met or exceeded the AI were higher than those with TWI less than AI (t = - 2.011, p = 0.046; t = - 2.716, p = 0.008). Among all participants, there was moderate correlation between water intakes (TFI/BW, FWI/BW and TWI/BW) and body fluid (ICF/BW,ECF/BW and TBW/BW) (p < 0.01 for all). Same correlations were found among both males and females.

CONCLUSION

There is a certain degree of association between water intake and body fluid. However, whether TFI or TWI achieve AI or not do not disturb the balance on the distribution of body fluid. More studies should be conducted to find the diagnostic threshold on TFI and TWI which may disrupt the distribution of body fluid so as to prevent related diseases.

TRIAL REGISTRATION

Chinese clinical trial registry. Name of the registry: Relationship of drinking water and urination. Trial registration number: ChiCTR-ROC-17010320. Date of registration: 01/04/2017. URL of trial registry record: http://www.chictr.org.cn/edit.aspx?pid=17601&htm=4.

Improved Sensitivity for Protein Turnover Quantification by Monitoring Immonium Ion Isotopologue Abundance

We describe an analytical strategy allowing for the direct quantification of stable isotope label incorporation in newly synthesized proteins following administration of the stable isotope tracer deuterium oxide. We present a demonstration of coupling high-resolution mass spectrometry, metabolic stable isotope labeling, and MS/MS-based isotopologue quantification for the measurement of protein turnover. Stable isotope labeling with deuterium oxide, followed by immonium ion isotopologue quantification, is a more sensitive strategy for determining protein fractional synthesis rates compared to peptide centric mass isotopomer distribution analysis approaches when labeling time and/or stable isotope tracer exposure is limited and, as such, offers a great advantage for human studies.

Implications of the variation in biological 18 O natural abundance in body water to inform use of Bayesian methods for modelling total energy expenditure when using doubly labelled water

RATIONALE

Variation in ¹⁸ O natural abundance can lead to errors in the calculation of total energy expenditure (TEE) when using the doubly labelled water (DLW) method. The use of Bayesian statistics allows a distribution to be assigned to ¹⁸ O natural abundance, thus allowing a best-fit value to be used in the calculation. The aim of this study was to calculate within-subject variation in ¹⁸ O natural abundance and apply this to our original working model for TEE calculation.

METHODS

Urine samples from a cohort of 99 women, dosed with 50 g of 20% ² H₂ O, undertaking a 14-day breast milk intake protocol, were analysed for ¹⁸ O. The within-subject variance was calculated and applied to a Bayesian model for the calculation of TEE in a separate cohort of 36 women. This cohort of 36 women had taken part in a DLW study and had been dosed with 80 mg/kg body weight ² H₂ O and 150 mg/kg body weight H₂ ¹⁸ O.

RESULTS

The average change in the δ¹⁸ O value from the 99 women was 1.14‰ (0.77) [0.99, 1.29], with the average within-subject ¹⁸ O natural abundance variance being 0.13‰² (0.25) [0.08, 0.18]. There were no significant differences in TEE (9745 (1414), 9804 (1460) and 9789 (1455) kJ/day, non-Bayesian, Bluck Bayesian and modified Bayesian models, respectively) between methods.

CONCLUSIONS

Our findings demonstrate that using a reduced natural variation in ¹⁸ O as calculated from a population does not impact significantly on the calculation of TEE in our model. It may therefore be more conservative to allow a larger variance to account for individual extremes.

Health effects of desalinated water: Role of electrolyte disturbance in cancer development

This review contends that "healthy" water in terms of electrolyte balance is as important as "pure" water in promoting public health. It considers the growing use of desalination (demineralization) technologies in drinking water treatment which often results in tap water with very low concentrations of sodium, potassium, magnesium and calcium. Ingestion of such water can lead to electrolyte abnormalities marked by hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia which are among the most common and recognizable features in cancer patients. The causal relationships between exposure to demineralized water and malignancies are poorly understood. This review highlights some of the epidemiological and in vivo evidence that link dysregulated electrolyte metabolism with carcinogenesis and the development of cancer hallmarks. It discusses how ingestion of demineralized water can have a procarcinogenic effect through mediating some of the critical pathways and processes in the cancer microenvironment such as angiogenesis, genomic instability, resistance to programmed cell death, sustained proliferative signaling, cell immortalization and tumorigenic inflammation. Evidence that hypoosmotic stress-response processes can upregulate a number of potential oncogenes is well supported by a number studies. In view of the rising production and consumption of demineralized water in most parts of the world, there is a strong need for further research on the biological importance and protean roles of electrolyte abnormalities in promoting, antagonizing or otherwise enabling the development of cancer. The countries of the Gulf Cooperative Council (GCC) where most people consume desalinated water would be a logical place to start this research.

Dynamic Proteomics: In Vivo Proteome-Wide Measurement of Protein Kinetics Using Metabolic Labeling

Control of biosynthetic and catabolic rates of polymers, including proteins, stands at the center of phenotype, physiologic adaptation, and disease pathogenesis. Advances in stable isotope-labeling concepts and mass spectrometric instrumentation now allow accurate in vivo measurement of protein synthesis and turnover rates, both for targeted proteins and for unbiased screening across the proteome. We describe here the underlying principles and operational protocols for measuring protein dynamics, focusing on metabolic labeling with (2)H2O (heavy water) combined with tandem mass spectrometric analysis of mass isotopomer abundances in trypsin-generated peptides. The core principles of combinatorial analysis (mass isotopomer distribution analysis or MIDA) are reviewed in detail, including practical advantages, limitations, and technical procedures to ensure optimal kinetic results. Technical factors include heavy water labeling protocols, optimal duration of labeling, clean up and simplification of sample matrices, accurate quantitation of mass isotopomer abundances in peptides, criteria for adequacy of mass spectrometric abundance measurements, and calculation algorithms. Some applications are described, including the noninvasive "virtual biopsy" strategy for measuring molecular flux rates in tissues through measurements in body fluids. In addition, application of heavy water labeling to measure flux lipidomics is noted. In summary, the combination of stable isotope labeling, particularly from (2)H2O, with tandem mass spectrometric analysis of mass isotopomer abundances in peptides, provides a powerful approach for characterizing the dynamics of proteins across the global proteome. Many applications in research and clinical medicine have been achieved and many others can be envisioned.

Water turnover assessment in overweight adolescents

Adequate intake (AI) standards for water in adolescents range between 2.4-3.3 l/day for males and 2.1-2.3 l/day for females, independent of obesity status. Water intakes and excretions of this population are not well documented. The purposes of this study were to assess water turnover, inputs, and outputs in overweight adolescents, compare these parameters between males and females, and evaluate the reproducibility of water turnover. Eighteen girls (BMI 31.7 ± 4 kg/m(2); mean ± s.d.) and nine boys (BMI 26.3 ± 3 kg/m(2)) aged 12-15 years completed two 3-week metabolic balance trials. Rate of water turnover (rH(2)O) was measured by tracking the decline of deuterated water from the body over 14 days. Water inputs (diet*, ad libitum(#), metabolic(#)) and outputs (urine*, feces*, insensible(#)) were assessed (*measured, #estimated). rH(2)O was lower (P = 0.002) in girls vs. boys (3,742 ± 536 vs. 4,537 ± 623 g/day). Per kg body weight, rH(2)O was 28% lower in girls vs. boys (46 ± 7 vs. 64 ± 9 g·kg(-1)·day(-1)). Water input from food and beverages provided and metabolic production were 44 and 28% lower, respectively, in girls vs. boys. Urine and insensible water losses were 21 and 17% lower in girls vs. boys. BMI was positively associated with water turnover in both sexes (girls P = 0.037; boys P = 0.014). The intraclass correlation of rH(2)O between trials was 0.981 (P < 0.001). In conclusion, these overweight adolescents consumed water well in excess of sex-specific AI standards. The lower rH(2)O in girls compared to boys is consistent with adult females and males.

A stable isotope method for the simultaneous measurement of matrix synthesis and cell proliferation in articular cartilage in vivo

OBJECTIVE

Measurements of cell proliferation and matrix synthesis in cartilage explants have identified regulatory factors [e.g., interleukin-1 (IL-1)] that contribute to osteoarthritis and anabolic mediators [e.g., bone morphogenic protein-7 (BMP-7)] that may have therapeutic potential. The objective of this study was to develop a robust method for measuring cell proliferation and glycosaminoglycan synthesis in articular cartilage that could be applied in vivo.

METHODS

A stable isotope-mass spectrometry approach was validated by measuring the metabolic effects of IL-1 and BMP-7 in cultures of mature and immature bovine cartilage explants. The method was also applied in vivo to quantify physiologic turnover rates of matrix and cells in the articular cartilage of normal rats. Heavy water was administered to explants in the culture medium and to rats via drinking water, and cartilage was analyzed for labeling of chondroitin sulfate (CS), hyaluronic acid (HA) and DNA.

RESULTS

As expected, IL-1 inhibited the synthesis of DNA and CS in cartilage explants. However, IL-1 inhibited HA synthesis only in immature cartilage. Furthermore, BMP-7 was generally stimulatory, but immature cartilage was significantly more responsive than mature cartilage, particularly in terms of HA and DNA synthesis. In vivo, labeling of CS and DNA in normal rats for up to a year indicated half-lives of 22 and 862 days, respectively, in the joint.

CONCLUSIONS

We describe a method by which deuterium from heavy water is traced into multiple metabolites from a single cartilage specimen to profile its metabolic activity. This method was demonstrated in tissue culture and rodents but may have significant clinical applications.

Comparison of Body Water Turnover in Endurance Runners and Age-matched Sedentary Men

This study compared the body water turnover in endurance athletes and age-matched sedentary men. Eight competitive endurance athletes (20.8+/-1.9 yr) and age-matched eight sedentary men (21.6+/-2.5 yr) participated in this study. Total body water and body water turnover were measured using the deuterium (D(2)O) dilution technique. Urine samples were obtained every day for 10 days after oral administration of D(2)O. The day-by-day concentrations were used to calculate the biological half-life of D(2)O and body water turnover. Maximal oxygen uptake (VO(2max)) and oxygen uptake corresponding to ventilatory threshold (VO(2VT)) as an index of aerobic capacity were determined during a graded exercise test. Both VO(2max) and VO(2VT) were higher in the exercise group than in the sedentary group (P<0.05). The biological half-life of D(2)O was significantly shorter in the exercise group than in the sedentary group (5.89+/-0.81 days vs. 7.52+/-0.77 days, P<0.05), and the percentage of the body water turnover was significantly higher in the exercise group than in the sedentary group (11.99+/-1.96% vs. 9.39+/-1.21%, P<0.05). The body water turnover was correlated with VO(2max) and VO(2VT), respectively (P<0.05). Based on these findings, this study speculates that a level of physical activity may induce a body water turnover higher in the healthy state, since the better trained subjects have a higher body water turnover.