Water and Exercise

Water

    Does not provide any food energy

    Essential as a medium in which reactions can occur

    Constitutes the majority of the body’s weight (60% in avg male; 50% in avg female)

    Most important for temperature regulation in the body

Water

    How much do you need per day?

   Approximately 2 to 3 quarts per day; taken in via fluids (25% of bottled water is actually purified tap water), food, metabolism

   Why?

   Water losses during day

   Via
v  Urinary output
v  Insensible perspiration
    - through skin (~30%)
v  Exhaled air
v  GI tract

Water

    Where is it stored in the body?

   65% is stored in the inside body cells (intracellular water)

   35% is outside the body cells (extracellular water)

   Intercellular (interstitial) is between and surrounding cells

   Intravascular is within the blood vessels

   Fluid shifts between these compartments during rest and exercise efforts

    Held in the body by protein, CHO, and electrolytes (sodium in particular)

Water

    How is body water regulated?

   By the kidney

  Normohydration (Euhydration) – normal body water levels

  Dehydration – loss of body water

  Hyperhydration – excess fluid retention by body

   Main feedback device

  Osmolality – amount of dissolved substances in solution

Water Control Mechanism

Major functions of water in body

    Building material for cells

    Protection of body tissues (can’t compress water)

    Control osmotic pressure inside body

    Major constituent of blood

    Essential for proper functioning of senses

    Regulation of body temperature

Electrolytes

    Defined as substances in water that conduct an electric current

    Major electrolytes in body

   Sodium, potassium, chloride, bicarbonate, sulfate, magnesium, and calcium

Electrolytes

    Sodium

   RDA: there is none at current time; avg minimum for adults is 500 mg/day but suggested to be 1,250-2,400 mg/day for athletes who sweat profusely

   Food Sources

  Found in natural and processed foods (more)

   Avg American takes in 4,000-4,800 mg/day

Electrolytes

    Sodium

   Major Functions

  Control of water balance and pressures; nerve transmission; muscle contraction

   Deficiency

  Concentration of sodium increases in blood during short-term exercise

  Prolonged exercise and sweating may decrease sodium amount, particularly in hot environment leading to heat problems

Electrolytes

    Chloride

   DRI minimum is 750 mg/day

   Food Sources

  Table salt, along with sodium

   Major Functions

  Water balance and electric potentials; formation of hydrochloric acid for digestion of food in stomach

   Deficiency

  Rare but significant sweating can result in heat problems

Electrolytes

    Potassium

   DRI minimum is 2,000 mg/day

   Food Sources

   Bananas, citrus fruits, fresh vegetables, milk, meat, fish

   Major Functions

   Water balance and electric potentials in nerves and muscles; transport of glucose into muscle, storage of energy in muscle

   Deficiency

   Rare but can occur during fasting, diarrhea, use of diuretics

   Symptoms included muscle weakness and heart stoppage

   Excess

   Heart ECG dysrhythmias can occur

Fluid and Electrolyte Losses

    How does environmental heat affect physical performance?

   Performance in strength, power, or speed events that last less than 1 minute is not adversely affected

   Performance in prolonged aerobic events is worse compared to cooler environments

Fluid and Electrolyte Losses

    How do dehydration and hypohydration affect physical performance?

   Studied from 2 perspectives:

  Voluntary dehydration

   Individual choses to lose weight, such as with wrestlers and boxers

  Involuntary dehydraton

   Water is lost as a result of training or competition; body attempting to maintain temperature homeostasis

   Note: Dehydration leads to hypohydration

Fluid and Electrolyte Losses

    Voluntary Dehydration

   Usually involves use of exercise-induced sweating, thermal-induced sweating such as saunas, diuretics to increase urine losses, and decreased intakes of fluids and foods

   4-8% losses in body weight (primarily water) have resulted in mixed results

   Some studies show no effect on performance in anaerobic events

   Anaerobic muscular endurance tasks lasting longer than 20-30 seconds have shown impaired performances, up to 15% drops in performance

   Impairments possibly due to loss of K+ in muscle and high temperatures in muscle

Fluid and Electrolyte Losses

    Involuntary Dehydration

   Usually associated with prolonged endurance events under warm, humid environmental conditions

   Less than 2% losses in body weight have shown significant decreases in performance

  The greater the losses, the greater the decrement in performance

  Decrements in performance are related to cardiovascular function and temperature regulation

   A 3% weight loss can decrease aerobic performance by 4-8% in a neutral environment
v Impairment would be greater in hot environment

Fluid and Electrolyte Losses

    Why are there decrements in performance with Involuntary Dehydration?

   Reduction in plasma volume

  Decreases cardiac output and skin blood flow

   Decreases in skin blood flow lower sweat rate and increase core temperature
   HR is increased and stroke volume is decreased

   Increased GI distress

  Symptoms of nausea, vomiting, bloating, cramps

   Disturbed fluid and electrolyte imbalances

   Cognitive function can be impaired with 1-2% dehydration

 

Fluid and Electrolyte Losses

    How fast does an individual dehydrate while exercising?

   Maximal sweat rate for a trained athlete is about 2-3 liters/hour; this results in a 2-3% decrease in body weight

  Note: 1 liter = 1 kg = 2.2 lbs

   So a 2 liter sweat loss would be equivalent to 4.4 lbs

  Football players can lose 5-6 kg (11-13 lbs) over the course of a day with multiple workouts

  Greater sweat losses usually occur with males compared with females

Fluid and Electrolyte Losses

    What is the composition of sweat?

   Depends on the type of sweat gland

   Apocrine

   Located in hairy areas of body
   Secrete an oily mixture to reduce friction from movement

   Eccrine (2-3 million)

   Located over surface of body
   Primarily involved with temperature regulation

   Sweat is 99% water & hypotonic (less [ ] of electrolytes compared with body fluids)

   Major electrolytes in sweat

   Sodium, chloride, along with other macro and microminerals

   Small quantities of N, amino acids & water-soluble vitamins

Fluid and Electrolyte Losses

    Does excessive sweating result in electrolyte deficiency?

   Levels of Na+ (water loss) and K+ (leakage from muscle and water loss) increase

   Levels of chloride and calcium remain unchanged

   Levels of Mg usually decrease (due to need from muscle, particularly for prolonged, endurance events)

   Prolonged events, without fluid replacement, have resulted in 5-7% decreases in Na+ and Chloride; K+ decrease of 1%

   Overall, no significant loss of electrolytes provided adequate fluid replacement occurs

Fluid, CHO, and Electrolyte Replacement

    Which is most important to replace during exercise in the heat?

   Water replacement is the primary consideration

   CHO drinks are important for maintaining glucose and glycogen energy sources in prolonged endurance events

   Electrolyte replacement is important in events with heavy sweat losses (e.g. ultra-marathons)

Fluid and Electrolyte Losses

    Guidelines for maintaining fluid balance during exercise

   Skin wetting with cold water

  Some suggest this to be detrimental due to decreased sensation of need to sweat

   Athletes increase effort without the body compensating for heat regulation inside the body

  Others suggest psychological sense of relief

  No proven benefit to performance; more research needs to be done

 

Fluid and Electrolyte Losses

    Guidelines for maintaining fluid balance during exercise

   Hyperhydration

   Increased hydration prior to an event in hot environment is likely to improve cardiovascular function and temperature regulation
   Recommendation
v 1 pint (16 oz) when waking in morning
v 1 pint at 1 hour before event
v 1 pint at 15-30 min before event

Fluid and Electrolyte Losses

    Guidelines for maintaining fluid balance during exercise

   Rehydration

   Shown to minimize the rise in core temperature, reduce stress on cardiovascular system, and help maintain optimal race pace (in events of 1 hour or more in the heat)
   May reduce loss of muscle glycogen
   Water ingested during exercise may appear in plasma and sweat within 10-20 minutes
v This will depend upon gastric emptying and intestinal absorption

Fluid and Electrolyte Losses

    What factors influence gastric emptying?

   Total volume of fluid intake

   Caloric density of drink

   Osmolality of drink

   Temperature of drink

   Exercise intensity

   Mode of exercise

   Dehydration state

Gastric Emptying

    Volume

   The larger the volume ingested (up to 700 ml), the greater the rate of emptying; larger volumes may cause discomfort

 

    Caloric Density

   6-8% glucose solution is recommended by ACSM; greater than 10% may slow emptying

Gastric Emptying

    Osmolality

   Adding electrolytes and CHO to fluids increase osmolality which slows emptying

  Glucose polymer-fructose solutions have shown lessened effect on gastric emptying

 

    Temperature of solution

   Cold fluids empty from stomach more rapidly than warm fluids

Gastric Emptying

    Exercise

   Moderate intensity exercise helps facilitate emptying while intensities around 70-75% VO2 max have a “slowing” effect on emptying

   Cycling does not differ from running during the initial hour of a long exercise; however, gastric emptying is quicker during later stages of prolonged cycling vs running

 

    Dehydration State

   Rate of gastric emptying not affected by 3% hypohydration, however greater water loss may slow gastric emptying

Intestinal Absorption

    Absorptive capacity of intestines does not limit the effectiveness of an oral rehydration solution

   Water absorption is helped by presence of glucose and sodium

   Glucose stimulates sodium absorption, and sodium is needed for glucose absorption

   Multiple forms of CHO appear to enhance absorption of water

   High intensity exercise may slow intestinal absorption of water

   Individual differences exist in regard to intestinal absorption

CHO replacement during exercise in heat

    Warm environments tend to accelerate use of muscle glycogen

    General findings

   GES and GPS solutions between 5-10% empty stomach as effectively as water

   1 gram of CHO per minute of prolonged activity is recommended

   Cola drinks or fruit juices may be diluted in half (equal parts cola and water)

   Higher CHO solutions delay gastric emptying and cause GI distress (excess gas production, flatulence, sensation of defecating, and cramping); more so in runners than cyclists

Electrolyte replacement during exercise in heat

     Electrolyte replacement is not necessary during exercise of durations less than 4 hours

    Amount of electrolytes in blood actually increase

    Excessive intake may aggravate electrolyte balance and impair performance

     Sodium intake of 20-30 mEq/L (1-2 grams of salt per liter) are recommended for prolonged events such as ultramarathons and triathlons

    Water intake alone, without some Na+ may lead to hyponatremia (subnormal amount of Na+ in blood)

     Chicken broth or chicken noodle soup has been shown to help with fluid retention after dehydration

Electrolyte replacement during exercise in heat

    Hydration Check

   Check body weight in morning; if you weigh several pounds less from previous day, you’re most likely hypohydrated

Are salt tablets or K+ supplements necessary for exercise in hot conditions?

    General Information

   Salt is 40% Na+ and 60% Cl

   Less salt will be lost in an acclimatized compared to an unacclimatized individual

   Average meal contains 2-3 grams of Na+

  Total for 3 meals is usually enough to cover Na+ lost in sweat

Are salt tablets or K+ supplements necessary for exercise in hot conditions?

    Recommendations for Salt Intake

   In general, salt tablets not needed with regular well-balanced meals

 

   10-25 grams of salt (4-10 g Na+) per day is recommended for athletes acclimatizing to heat over 1-2 week period; 2-3 grams for sedentary individuals acclimatizing to heat

Are salt tablets or K+ supplements necessary for exercise in hot conditions?

    Recommendations for Salt Intake

   Salt tablets should only be taken if athlete needs to drink more than 4 quarts of water/day to replace weight loss (8 lbs); i.e. 1 pint of water per salt tablet; (1 pint=1 lb)

 

   After 6-9 days of acclimatizing, use of salt tablets should be discontinued

Are salt tablets or K+ supplements necessary for exercise in hot conditions?

    Recommendations for K+ supplements

   Not recommended

   A large glass of orange juice will replace K+ lost in 2 liters of sweat

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           Before Competition

          Be well-trained and acclimatized

          Be well-hydrated the day before and morning of competition

        Hyperhydrate (10-17 oz or 300-500 ml) of cold fluid at 15-30 minutes before exercising

       If exercise is prolonged, add CHO to fluid (6-8% glucose solution)

          Minimize consumption of alcoholic beverages the night before competition; could lead to hypohydration

          Avoid drinking caffeinated beverages 1-4 hours prior to competition; may increase urine production during rest

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           During Competition

         Drink cold water (40-50oF or 4.4-10oC) when CHO intake is of no concern, i.e. events less than 50-60 minutes

         For events longer than 60 minutes, CHO drinks (6-8%) should be considered; multiple forms (glucose, sucrose, fructose, glucose polymers) of CHO drinks may be helpful

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           During Competition

3. Drinks should contain small amounts of electrolytes, particularly for events of prolonged duration (4-5 hrs)

        460-690 mg Na+/liter

        200-400 mg K+/liter

4. Fluid should be palatable

        Cold and sweet enhances palatability

        Carbonated beverages nor use of aspartame don’t appear to inhibit gastric emptying; however less fluid is usually consumed

        Citric acid may impair gastric emptying by 25%

        Caffeinated drinks don’t appear to have detrimental effect when consumed during exercise

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           During Competition

5. Rehydrate with 6-8 oz (180-240 ml) of cold fluid during exercise at 10-15 minute intervals

        One normal mouthful/swallow = 1 ounce

        Per minute, 50 ml of fluid may be lost through sweating (up to 3 liters per hour) but only 20-30 ml of fluid may be absorbed from intestines in that time

4. Rehydrate early in endurance events

        Thirst does not develop until ~ 1-2% of body wt has been dehydrated

Note: dehydration may impair gastric emptying and cause GI distress

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           After Competition

1. Consume enough fluids to regain body weight losses

        Consume 150% of body wt loss; or 24 ounces of fluid for each 16 oz lost

        Consume fluids with high CHO content; fruit juices and sport drinks are good choices

       Combining CHO with protein in drinks may speed rate of glycogen replacement

2. Consume drinks with some Na+ or you can add some salt on your foods

3. Avoid caffeinated beverages

      a. These can increase electrolyte losses during recovery

4. Avoid alcoholic beverages containing 4% or more alcohol

      a. These delay restoration of blood volume

Prudent Recommendations of Fluid Replacement with Exercise in Hot Conditions

           In Training

1. Practice consuming fluids while you train

       Consuming GES during training may result in more effective workout

       Try different fluid combinations at various training intensities to determine what works best for you

Ergogenic Effects of Water

    Compared to taking no fluid before or during competition, hyperhydration and rehydration can enhance temperature regulation and exercise performance

   Long duration performances are affected the most when not getting proper hydration

   Diuretic-induced water losses have been shown to be effective for high jumpers

   Can develop same power output but with less body weight

   Use of diuretics is banned by USOC and NCAA

   Extra Na+ ingestion may theoretically increase blood volume leading to better cardiovascular responses but no advantages have been reported

Does glycerol supplementation enhance endurance performance in hot weather?

    Glycerol + water hyperhydration

   Suggested to increase osmotic pressure of body fluids which may increase blood volume

   This could enhance temperature regulation, hence improve performance

   For each kg of body wt, 1 g of glycerol is combined with water

   Some studies have shown twice as much water is retained with glycerol-induced hyperhydration; others show no advantages

   Studies have shown improvements in endurance cycling performance; others show no benefit – runners have to use more energy to move water around

   Suggested improvement in giving body builders “cut” appearance

Does glycerol supplementation enhance endurance performance in hot weather?

    Glycerol + water hyperhydration

   Should be cautious in excess use of glycerol since it may increase pressures in intracellular spaces causing tissue damage; also may cause nausea, vomiting, headaches

   Glycerate is the commercial product

  Pro Hydrator contains glycerol

  Glycerine is sold in stores

   This must be diluted, not taken internally in store form
v Dilution is 36 ml of glycerol with 955 ml of water for each 100 lbs of body wt (1.25 oz per quart of water)

Does sodium bicarbonate (soda loading) improve performance?

    Sodium bicarbonate (baking soda) is an alkaline salt found naturally in the body which controls excessive acidity

   During high intensity anaerobic exercise, it can buffer large amount of lactic acid accumulation in the blood

   It can have potential benefits on each of the energy systems

Does sodium bicarbonate (soda loading) improve performance?

    Sodium bicarbonate and the energy systems

   ATP-PC system

  No ergogenic effect on intense efforts < 30 seconds or resistance exercise tasks

Does sodium bicarbonate (soda loading) improve performance?

    Sodium bicarbonate and the energy systems

   Lactic acid system

   Ingestion of sodium bicarbonate or sodium citrate has generally shown:

   Decreased acidosis in the muscle
   Decrease “sense” of fatigue during exercise
   Increase in exercise performance in events of 1-3 minutes of high intensity

   Other studies suggest no improvement in performance but not hindrance either

   If taken, recommendation

   Take 0.15-0.30 g sodium bicarbonate per kg body wt (< 1 oz for avg adult)
   Take dosage 1-3 hours prior to exercise task

Does sodium bicarbonate (soda loading) improve performance?

    Sodium bicarbonate and the energy systems

   Oxygen system

  Some studies suggest a beneficial effect on performance in events of 4-5 minutes duration and possibly up to 60 minutes of exercise effort

  Other studies have shown no benefit in maximal runs of 4-30 minutes duration

Sodium Bicarbonate Use

    Safety

   Generally safe, but excessive dosages may cause GI distress or alkalosis with symptoms of apathy, irritability, and muscle spasms

    Legality

   Still legal to use soda loading

  No test to detect its use, except for urinary pH

   Difficult to quantify since this may be affected by antacids

Water and Health Aspects

    Heat Injuries

   Heat Syncope

   Heat Cramps

   Salt-depletion heat exhaustion

   Water-depletion heat exhaustion

   Anhidrotic heat exhaustion

   Heat Stroke

Heat Syncope

Heat Cramps

Salt-depletion Heat Exhaustion

Water-depletion Heat Exhaustion

Anhidrotic Heat Exhaustion

Heat Stroke

How do you reduce problems with exercising in heat?

            Check temp and humidity before exercise

            Exercise in morning or evening

            Exercise in the shade; wear sunscreen

            Wear thin clothing that is loose to allow air circulation; loose hat in the sun

            Run into breeze in latter portion of your run

            Drink cool fluids periodically (6-8 oz every 10-15 min)

            Replenish water daily (drink 16-24 oz/pound lost)

            Hyperhydrate if performing prolonged strenuous exercise (16-32 oz at 30-60 min prior to start of exercise)

How do you reduce problems with exercising in heat?

9.   Replenish lost electrolytes (salt) if sweating excessively

10. Avoid excessive intake of protein; protein metabolism increases heat production by body

11. Avoid consuming caffeinated beverages several hours before exercise; it is a diuretic and increases metabolism

12. Avoid alcohol the evening before exercise

13. If out-of-shape, exercise at low intensities

14. Be aware of signs and symptoms of heat illnesses

15. Don’t exercise when ill or had fever recently

16. Become acclimatized to heat before exercising in warm-hot competitive conditions

How do you become acclimatized?

    Living in a warm environment will confer some adjustment to heat

    Physical training will provide ~50% acclimation and increase body water levels

    Techniques for acclimatization (takes 7-14 days; longer for children)

   Cut down the amount and intensity of exercise in beginning stages of acclimation

   Increase amount and intensity of exercise as adjustment to heat occurs

   Mimic warm/hot environment in temperate areas

   Exercise in warm environments

   Wear extra layers of clothes

Physiological responses to acclimatization

              Plasma volume expands resulting in greater total blood volume; blood vessels conserving more protein and Na+

            Extra blood volume allows for greater stroke volume

            More blood volume allows more O2 and nutrient delivery to muscles; more blood to skin to allow for more efficient cooling

            Less muscle glycogen is used, sparing important energy for performance

            Sweat glands hypertrophy and secrete 30% more sweat; greater evaporation

 

Physiological responses to acclimatization

6.   The amount of salt in sweat decreases by ~ 60%; evaporation is more efficient and electrolytes are conserved

7.   Sweating starts sooner at a lower core temperature

8.   Core temperature will not rise as high or as rapidly as when it did in unacclimatized state

9.   Psychological feeling of stress is reduced during exercise