Fluid and fuel intake during exercise

The amounts of water, carbohydrate and salt that athletes are advised to ingest during exercise are based upon their effectiveness in attenuating both fatigue as well as illness due to hyperthermia, dehydration or hyperhydration. When possible, fluid should be ingested at rates that most closely match sweating rate. When that is not possible or practical or sufficiently ergogenic, some athletes might tolerate body water losses amounting to 2% of body weight without significant risk to physical well-being or performance when the environment is cold (e.g. 5–10°C) or temperate (e.g. 21–22°C). However, when exercising in a hot environment ( >30°C), dehydration by 2% of body weight impairs absolute power production and predisposes individuals to heat injury. Fluid should not be ingested at rates in excess of sweating rate and thus body water and weight should not increase during exercise. Fatigue can be reduced by adding carbohydrate to the fluids consumed so that 30–60 g of rapidly absorbed carbohydrate are ingested throughout each hour of an athletic event. Furthermore, sodium should be included in fluids consumed during exercise lasting longer than 2 h or by individuals during any event that stimulates heavy sodium loss (more than 3–4 g of sodium). Athletes do not benefit by ingesting glycerol, amino acids or alleged precursors of neurotransmitter. Ingestion of other substances during exercise, with the possible exception of caffeine, is discouraged. Athletes will benefit the most by tailoring their individual needs for water, carbohydrate and salt to the specific challenges of their sport, especially considering the environment's impact on sweating and heat stress.

[1]  M. Hargreaves Carbohydrates and exercise performance. , 2009, Nutrition reviews.

[2]  T D Noakes,et al.  Water Intoxication: A Possible Complication During Endurance Exercise , 2005, Medicine and science in sports and exercise.

[3]  R. Wolfe,et al.  Protein and amino acids for athletes , 2004, Journal of sports sciences.

[4]  Louise M Burke,et al.  Carbohydrates and fat for training and recovery , 2004, Journal of sports sciences.

[5]  J Bangsbo,et al.  The physiology of soccer--with special reference to intense intermittent exercise. , 2003, Acta physiologica Scandinavica. Supplementum.

[6]  M. Sawka,et al.  Fluid balance and endurance exercise performance. , 2003, Current sports medicine reports.

[7]  T. Noakes Overconsumption of fluids by athletes , 2003, BMJ : British Medical Journal.

[8]  José González-Alonso,et al.  Reductions in Systemic and Skeletal Muscle Blood Flow and Oxygen Delivery Limit Maximal Aerobic Capacity in Humans , 2003, Circulation.

[9]  T. McCauley,et al.  Early postexercise muscle glycogen recovery is enhanced with a carbohydrate-protein supplement. , 2002, Journal of applied physiology.

[10]  David T Martin,et al.  Effect of different protocols of caffeine intake on metabolism and endurance performance. , 2002, Journal of applied physiology.

[11]  J. Davis,et al.  Carbohydrates and physical/mental performance during intermittent exercise to fatigue. , 2002, Medicine and science in sports and exercise.

[12]  M. Sawka,et al.  Physical Exercise and Exhaustion from Heat Strain , 2001 .

[13]  T. Noakes,et al.  Response to a fluid load in athletes with a history of exercise induced hyponatremia. , 2001, Medicine and science in sports and exercise.

[14]  M. Sawka,et al.  Hyponatremia Associated With Exercise: Risk Factors and Pathogenesis , 2001, Exercise and sport sciences reviews.

[15]  A. Hardman,et al.  Moderate exercise, postprandial lipemia, and skeletal muscle lipoprotein lipase activity. , 2001, Metabolism: clinical and experimental.

[16]  M. Sawka,et al.  Hyponatremia associated with overhydration in U.S. Army trainees. , 2001, Military medicine.

[17]  M. Sawka,et al.  Hydration effects on thermoregulation and performance in the heat. , 2001, Comparative biochemistry and physiology. Part A, Molecular & integrative physiology.

[18]  B. Nielsen,et al.  Brain activity and fatigue during prolonged exercise in the heat , 2001, Pflügers Archiv.

[19]  M. Sawka,et al.  Hyperhydration and glycerol: thermoregulatory effects during exercise in hot climates. , 2000, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[20]  Davis Jm,et al.  Effects of carbohydrate and chromium ingestion during intermittent high-intensity exercise to fatigue. , 2000 .

[21]  M N Sawka,et al.  Fluid and electrolyte supplementation for exercise heat stress. , 2000, The American journal of clinical nutrition.

[22]  J. Davis,et al.  Serotonin and central nervous system fatigue: nutritional considerations. , 2000, The American journal of clinical nutrition.

[23]  D. Faux,et al.  Analytical solutions for strain in pyramidal quantum dots , 2000 .

[24]  J A Stone,et al.  National athletic trainers' association position statement: fluid replacement for athletes. , 2000, Journal of athletic training.

[25]  E. Coyle,et al.  Water and carbohydrate ingestion during prolonged exercise increase maximal neuromuscular power. , 2000, Journal of applied physiology.

[26]  E. Coyle,et al.  Stroke volume during exercise: interaction of environment and hydration. , 2000, American journal of physiology. Heart and circulatory physiology.

[27]  R. Wolfe,et al.  An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exercise. , 2000, Journal of applied physiology.

[28]  G Sjøgaard,et al.  Dynamics and consequences of potassium shifts in skeletal muscle and heart during exercise. , 2000, Physiological reviews.

[29]  R. Maughan,et al.  The effects of substrate and fluid provision on thermoregulatory and metabolic responses to prolonged exercise in a hot environment , 2000, Journal of sports sciences.

[30]  Clyde Williams,et al.  The Loughborough Intermittent Shuttle Test: A field test that simulates the activity pattern of soccer , 2000, Journal of sports sciences.

[31]  M. Tarnopolsky,et al.  Low glycogen and branched-chain amino acid ingestion do not impair anaplerosis during exercise in humans. , 1999, Journal of applied physiology.

[32]  B. Nielsen,et al.  Metabolic and thermodynamic responses to dehydration‐induced reductions in muscle blood flow in exercising humans , 1999, The Journal of physiology.

[33]  C. Willíams,et al.  Carbohydrate-electrolyte ingestion during intermittent high-intensity running. , 1999, Medicine and science in sports and exercise.

[34]  J. Davis,et al.  Effects of Branched-Chain Amino Acids and Carbohydrate on Fatigue During Intermittent, High-Intensity Running , 1999, International journal of sports medicine.

[35]  D. Vrijens,et al.  Sodium-free fluid ingestion decreases plasma sodium during exercise in the heat. , 1999, Journal of applied physiology.

[36]  S. Barr,et al.  Effects of dehydration on exercise performance. , 1999, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[37]  F. Jensen,et al.  Influence of body temperature on the development of fatigue during prolonged exercise in the heat. , 1999, Journal of applied physiology.

[38]  G. McConell,et al.  Fluid ingestion does not influence intense 1-h exercise performance in a mild environment. , 1999, Medicine and science in sports and exercise.

[39]  K. Frayn,et al.  Effects of an oral and intravenous fat load on adipose tissue and forearm lipid metabolism. , 1999, American journal of physiology. Endocrinology and metabolism.

[40]  B. Nielsen,et al.  Muscle blood flow is reduced with dehydration during prolonged exercise in humans , 1998, The Journal of physiology.

[41]  K. Sugiura,et al.  Effect of carbohydrate ingestion on sprint performance following continuous and intermittent exercise. , 1998, Medicine and science in sports and exercise.

[42]  J. González-Alonso Separate and Combined Influences of Dehydration and Hyperthermia on Cardiovascular Responses to Exercise , 1998, International journal of sports medicine.

[43]  E. Eichner Treatment of Suspected Heat Illness , 1998, International journal of sports medicine.

[44]  Eichner Er Treatment of suspected heat illness , 1998 .

[45]  M. Febbraio,et al.  Effect of carbohydrate or carbohydrate plus medium-chain triglyceride ingestion on cycling time trial performance. , 1998, Journal of applied physiology.

[46]  R. Maughan,et al.  The effects of substrate and fluid provision on thermoregulatory, cardiorespiratory and metabolic responses to prolonged exercise in a cold environment in man , 1998, Experimental physiology.

[47]  L. J. McCutcheon,et al.  Sweating. Fluid and ion losses and replacement. , 1998, The Veterinary clinics of North America. Equine practice.

[48]  K. Ebersole,et al.  The Effect of Fluid Replacement on Endurance Performance , 1998, Journal of strength and conditioning research.

[49]  R. Wolfe,et al.  Exercise-induced changes in protein metabolism. , 1998, Acta physiologica Scandinavica.

[50]  J. Davis,et al.  Carbohydrate drinks delay fatigue during intermittent, high-intensity cycling in active men and women. , 1997, International journal of sport nutrition.

[51]  G. Biolo,et al.  An abundant supply of amino acids enhances the metabolic effect of exercise on muscle protein. , 1997, The American journal of physiology.

[52]  J. Cunningham Is potassium needed in sports drinks for fluid replacement during exercise? , 1997, International journal of sport nutrition.

[53]  G. Mack,et al.  Influence of sodium replacement on fluid ingestion following exercise-induced dehydration. , 1997, International journal of sport nutrition.

[54]  G. McConell,et al.  Influence of ingested fluid volume on physiological responses during prolonged exercise. , 1997, Acta physiologica Scandinavica.

[55]  E. Coyle,et al.  Dehydration markedly impairs cardiovascular function in hyperthermic endurance athletes during exercise. , 1997, Journal of applied physiology.

[56]  T. Snow,et al.  Water versus carbohydrate-electrolyte ingestion before and during a 15-km run in the heat. , 1997, International journal of sport nutrition.

[57]  C. Willíams,et al.  Effect of water ingestion on endurance capacity during prolonged running. , 1996, Journal of sports sciences.

[58]  Gary W. Mack,et al.  Exercise and Fluid Replacement , 1996 .

[59]  M. Febbraio,et al.  Effect of CHO ingestion on exercise metabolism and performance in different ambient temperatures. , 1996, Medicine and science in sports and exercise.

[60]  M. Febbraio,et al.  Influence of elevated muscle temperature on metabolism during intense, dynamic exercise. , 1996, The American journal of physiology.

[61]  P. Dutta,et al.  Nature of compensating luminescence centers in Te-diffused and -doped GaSb , 1996 .

[62]  T. Noakes,et al.  Effects of medium-chain triglyceride ingestion on fuel metabolism and cycling performance. , 1996, Journal of applied physiology.

[63]  O. Bar-or,et al.  Effect of drink flavor and NaCL on voluntary drinking and hydration in boys exercising in the heat. , 1996, Journal of applied physiology.

[64]  M. Sawka,et al.  Glycerol hyperhydration: hormonal, renal, and vascular fluid responses. , 1995, Journal of applied physiology.

[65]  E. Coyle,et al.  Dehydration reduces cardiac output and increases systemic and cutaneous vascular resistance during exercise. , 1995, Journal of applied physiology.

[66]  A. Jeukendrup,et al.  Metabolic availability of medium-chain triglycerides coingested with carbohydrates during prolonged exercise. , 1995, Journal of applied physiology.

[67]  C. Willíams,et al.  Influence of ingesting a carbohydrate-electrolyte solution on endurance capacity during intermittent, high-intensity shuttle running. , 1995, Journal of sports sciences.

[68]  J. Davis,et al.  Carbohydrates, branched-chain amino acids, and endurance: the central fatigue hypothesis. , 1995, International journal of sport nutrition.

[69]  L. Spriet,et al.  Caffeine and performance. , 1995, International journal of sport nutrition.

[70]  M. Millard-Stafford,et al.  Fluid intake in male and female runners during a 40-km field run in the heat. , 1995, Journal of sports sciences.

[71]  G. Biolo,et al.  Increased rates of muscle protein turnover and amino acid transport after resistance exercise in humans. , 1995, The American journal of physiology.

[72]  E. Coyle,et al.  Fluid and carbohydrate ingestion independently improve performance during 1 h of intense exercise. , 1995, Medicine and science in sports and exercise.

[73]  T D Noakes,et al.  Impaired High-Intensity Cycling Performance Time at Low Levels of Dehydration , 1994, International journal of sports medicine.

[74]  N. Rehrer The Maintenance of Fluid Balance During Exercise , 1994, International journal of sports medicine.

[75]  M. Febbraio,et al.  Influence of sodium on glucose bioavailability during exercise. , 1994, Medicine and science in sports and exercise.

[76]  C. Gisolfi,et al.  Intestinal absorption during rest and exercise: implications for formulating an oral rehydration solution (ORS). Proceedings of a roundtable discussion. April 21-22, 1993. , 1994, Medicine and science in sports and exercise.

[77]  W. Saris,et al.  Oxidation rates of orally ingested carbohydrates during prolonged exercise in men. , 1993, Journal of applied physiology.

[78]  E. Coyle,et al.  Influence of the timing of fluid ingestion on temperature regulation during exercise. , 1993, Journal of applied physiology.

[79]  P. Deuster,et al.  Responses of plasma magnesium and other cations to fluid replacement during exercise. , 1993, Journal of the American College of Nutrition.

[80]  D. MacLean,et al.  Branched-chain amino acid supplementation augments plasma ammonia responses during exercise in humans. , 1993, Journal of applied physiology.

[81]  C. Willíams,et al.  Fluid replacement in sport and exercise--a consensus statement. , 1993, British journal of sports medicine.

[82]  M. Manore,et al.  Diet and exercise strategies of a world-class bodybuilder. , 1993, International journal of sport nutrition.

[83]  S. Powers,et al.  Fluid replacement beverages and maintenance of plasma volume during exercise: role of aldosterone and vasopressin , 1992, European Journal of Applied Physiology and Occupational Physiology.

[84]  E. Coyle,et al.  Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. , 1992, Journal of applied physiology.

[85]  E. Coyle,et al.  Carbohydrate and fluid ingestion during exercise: are there trade-offs? , 1992, Medicine and science in sports and exercise.

[86]  E. Richter,et al.  Increased plasma FFA uptake and oxidation during prolonged exercise in trained vs. untrained humans. , 1992, The American journal of physiology.

[87]  J. Ivy,et al.  Carbohydrate-protein complex increases the rate of muscle glycogen storage after exercise. , 1992, Journal of applied physiology.

[88]  M. Millard-Stafford Fluid Replacement During Exercise in the Heat , 1992, Sports medicine.

[89]  K. Westerterp,et al.  Gastric emptying, absorption, and carbohydrate oxidation during prolonged exercise. , 1992, Journal of applied physiology.

[90]  J. Seifert,et al.  Physiological responses to glycerol ingestion during exercise. , 1991, Journal of applied physiology.

[91]  D. Costill,et al.  Fluid replacement during prolonged exercise: effects of water, saline, or no fluid. , 1991, Medicine and science in sports and exercise.

[92]  J. Bangsbo,et al.  Activity profile of competition soccer. , 1991, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[93]  T D Noakes,et al.  Metabolic rate, not percent dehydration, predicts rectal temperature in marathon runners. , 1991, Medicine and science in sports and exercise.

[94]  R. Maughan,et al.  The importance of volume in regulating gastric emptying. , 1991, Medicine and science in sports and exercise.

[95]  M. L. Riedesel,et al.  Effects of glycerol-induced hyperhydration prior to exercise in the heat on sweating and core temperature. , 1990, Medicine and science in sports and exercise.

[96]  D. Pascoe,et al.  Influence of carbohydrate dosage on exercise performance and glycogen metabolism. , 1989, Journal of applied physiology.

[97]  D. Costill,et al.  Water: can the endurance athlete get too much of a good thing? , 1989, Journal of the American Dietetic Association.

[98]  J. Seifert,et al.  The effects of glucose, fructose, and sucrose ingestion during exercise. , 1989, Medicine and science in sports and exercise.

[99]  E. Coyle,et al.  Effect of carbohydrate feedings during high-intensity exercise. , 1988, Journal of applied physiology.

[100]  E. Newsholme,et al.  Changes in plasma concentrations of aromatic and branched-chain amino acids during sustained exercise in man and their possible role in fatigue. , 1988, Acta physiologica Scandinavica.

[101]  J. Seifert,et al.  The effect of fluid and carbohydrate feedings during intermittent cycling exercise. , 1987, Medicine and science in sports and exercise.

[102]  E. Coyle,et al.  Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate. , 1986, Journal of applied physiology.

[103]  R. Maughan,et al.  Thermoregulation in Marathon Competition at Low Ambient Temperature* , 1985, International journal of sports medicine.

[104]  R. Maughan,et al.  Temperature regulation during marathon competition. , 1984, British journal of sports medicine.

[105]  Prevention of thermal injuries during distance running , 1984, The Medical journal of Australia.

[106]  B. Sandick,et al.  Voluntary dehydration and alliesthesia for water. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[107]  D. Costill,et al.  Nutrition for Endurance Sport: Carbohydrate and Fluid Balance* , 1980 .

[108]  S. Horvath,et al.  Thermoregulatory responses during competitive marathon running. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[109]  Y. Shapiro,et al.  Enzyme blood levels and water balance during a marathon race. , 1974, Journal of applied physiology.

[110]  A. Peter Holm,et al.  MEDICINE AND SCIENCE IN SPORTS , 1969 .

[111]  Wyndham Ch,et al.  The danger of an inadequate water intake during marathon running. , 1969 .

[112]  E Hultman,et al.  Diet, muscle glycogen and physical performance. , 1967, Acta physiologica Scandinavica.

[113]  L G Pugh,et al.  Rectal temperatures, weight losses, and sweat rates in marathon running. , 1967, Journal of applied physiology.

[114]  W S LADELL,et al.  The effects of water and salt intake upon the performance of men working in hot and humid environments , 1955, The Journal of physiology.

[115]  E. C. B. B. DEMONSTRATIONS OF PHYSICAL SIGNS IN CLINICAL SURGERY , 1948 .

[116]  R. E. Johnson,et al.  WORK IN THE HEAT AS AFFECTED BY INTAKE OF WATER, SALT AND GLUCOSE , 1944 .

[117]  S. Powers,et al.  Fluid replacement drinks during high intensity exercise effects on minimizing exercise-induced disturbances in homeostasis , 2004, European Journal of Applied Physiology and Occupational Physiology.

[118]  T. Noakes,et al.  Water ingestion does not improve 1-h cycling performance in moderate ambient temperatures , 2004, European Journal of Applied Physiology and Occupational Physiology.

[119]  Marc T. Hamilton,et al.  Effects of carbohydrate feedings on plasma free tryptophan and branched-chain amino acids during prolonged cycling , 2004, European Journal of Applied Physiology and Occupational Physiology.

[120]  R. Wolfe,et al.  Acute response of net muscle protein balance reflects 24-h balance after exercise and amino acid ingestion. , 2003, American journal of physiology. Endocrinology and metabolism.

[121]  Lars Nybo,et al.  Cerebral Changes During Exercise in the Heat , 2003, Sports medicine.

[122]  David Martin,et al.  IMMDA ADVISORY STATEMENT ON GUIDELINES FOR FLUID REPLACEMENT DURING MARATHON RUNNING , 2002 .

[123]  J. Ivy Dietary strategies to promote glycogen synthesis after exercise. , 2001, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[124]  N. Rehrer Fluid and Electrolyte Balance in Ultra-Endurance Sport , 2001, Sports medicine.

[125]  J M Davis,et al.  Effects of carbohydrate and chromium ingestion during intermittent high-intensity exercise to fatigue. , 2000, International journal of sport nutrition and exercise metabolism.

[126]  E. Coyle,et al.  Preexercise medium-chain triglyceride ingestion does not alter muscle glycogen use during exercise. , 2000, Journal of applied physiology.

[127]  M N Sawka,et al.  Influence of body water and blood volume on thermoregulation and exercise performance in the heat. , 1999, Exercise and sport sciences reviews.

[128]  C. Willíams,et al.  The influence of intermittent high-intensity shuttle running and fluid ingestion on the performance of a soccer skill. , 1999, Journal of sports sciences.

[129]  A. Jeukendrup,et al.  Effects of carbohydrate (CHO) and fat supplementation on CHO metabolism during prolonged exercise. , 1996, Metabolism: clinical and experimental.

[130]  M. Febbraio,et al.  Effect of fluid ingestion on muscle metabolism during prolonged exercise. , 1996, Journal of applied physiology.

[131]  J M Davis,et al.  Central and peripheral factors in fatigue. , 1995, Journal of sports sciences.

[132]  Davis Jm,et al.  Central and peripheral factors in fatigue , 1995 .

[133]  R. Maughan,et al.  Fluid replacement requirements in soccer. , 1994, Journal of sports sciences.

[134]  W. Saris,et al.  Effects of electrolytes in carbohydrate beverages on gastric emptying and secretion. , 1993, Medicine and science in sports and exercise.

[135]  E. Coyle,et al.  Benefits of fluid replacement with carbohydrate during exercise. , 1992, Medicine and science in sports and exercise.

[136]  R. Maughan,et al.  Fluid and electrolyte loss and replacement in exercise. , 1991, Journal of sports sciences.

[137]  E. Coyle,et al.  Carbohydrate ingestion during prolonged exercise: effects on metabolism and performance. , 1991, Exercise and sport sciences reviews.

[138]  J. Ivy,et al.  Muscle Glycogen Synthesis Before and After Exercise , 1991, Sports medicine.

[139]  R. S. Read,et al.  Sports nutrition. Approaching the nineties. , 1989, Sports medicine.

[140]  Koivisto Va The physiology of marathon running. , 1986, Science progress.

[141]  J. Décombaz,et al.  Nutrient intake and energy regulation in physical exercise. , 1983, Experientia. Supplementum.

[142]  E. Coyle,et al.  Effect of glycerol feeding on endurance and metabolism during prolonged exercise in man. , 1983, Medicine and science in sports and exercise.

[143]  R. Fell,et al.  Effects of glycerol feeding before and after exhausting exercise in rats. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[144]  D. Costill,et al.  Influence of caffeine and carbohydrate feedings on endurance performance. , 1979, Medicine and science in sports.

[145]  G. Dalsky,et al.  Effects of caffeine ingestion on metabolism and exercise performance. , 1978, Medicine and science in sports.

[146]  E. Coyle,et al.  Gastric emptying rates for selected athletic drinks. , 1978, Research quarterly.

[147]  N. B. Strydom,et al.  The danger of an inadequate water intake during marathon running. , 1969, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.