National athletic trainers' association position statement: fluid replacement for athletes.

OBJECTIVE To present recommendations to optimize the fluid-replacement practices of athletes. BACKGROUND Dehydration can compromise athletic performance and increase the risk of exertional heat injury. Athletes do not voluntarily drink sufficient water to prevent dehydration during physical activity. Drinking behavior can be modified by education, increasing accessibility, and optimizing palatability. However, excessive overdrinking should be avoided because it can also compromise physical performance and health. We provide practical recommendations regarding fluid replacement for athletes. RECOMMENDATIONS Educate athletes regarding the risks of dehydration and overhydration on health and physical performance. Work with individual athletes to develop fluid-replacement practices that optimize hydration status before, during, and after competition.

[1]  P. F. Iampietro,et al.  Work Performance After Dehydration: Effects of Physical Conditioning and Heat Acclimatization , 1958, Journal of applied physiology.

[2]  J. Mitchell,et al.  The effect of preexercise carbohydrate status on resistance exercise performance. , 1997, International Journal of Sport Nutrition.

[3]  G. Naughton,et al.  Examination of the self-selected fluid intake practices by junior athletes during a simulated duathlon event. , 1998, International journal of sport nutrition.

[4]  B. Nielsen.  Olympics in Atlanta: a fight against physics. , 1996, Medicine and science in sports and exercise.

[5]  J. Davis,et al.  Failure of low dose carbohydrate feeding to attenuate glucoregulatory hormone responses and improve endurance performance. , 1991, International journal of sport nutrition.

[6]  D. Riebe,et al.  Intravenous vs. oral rehydration: effects on subsequent exercise-heat stress. , 1996, Journal of applied physiology.

[7]  Bijlani Rl,et al.  Effect of dehydration and a few regimes of rehydration on human performance. , 1980 .

[8]  P. F. Iampietro,et al.  Relation of climate and temperature to food and water intake in man. , 1958, Metabolism: clinical and experimental.

[9]  C. Horswill.  Effective fluid replacement. , 1998, International journal of sport nutrition.

[10]  S. Shirreffs,et al.  Urine osmolality and conductivity as indices of hydration status in athletes in the heat. , 1998, Medicine and science in sports and exercise.

[11]  E. Nadel,et al.  Effect of blood volume on sweating rate and body fluids in exercising humans. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[12]  T. Itoh,et al.  Thermoregulation and body fluid in hot environment. , 1998, Progress in brain research.

[13]  W. Frontera,et al.  Effects of Hyperhydration on Total Body Water, Temperature Regulation and Performance of Elite Young Soccer Players in a Warm Climate , 1996, International journal of sports medicine.

[14]  T D Noakes,et al.  Carbohydrate-Loading and Exercise Performance , 1997, Sports medicine.

[15]  Susan M. Shirreffs,et al.  Rehydration and recovery after exercise. , 2004 .

[16]  L. Armstrong,et al.  Intravenous versus oral rehydration during a brief period: responses to subsequent exercise in the heat. , 2000, Medicine and science in sports and exercise.

[17]  J. Boulant,et al.  Effects of osmotic pressure, glucose, and temperature on neurons in preoptic tissue slices. , 1984, The American journal of physiology.

[18]  R. Murray.  The Effects of Consuming Carbohydrate-Electrolyte Beverages on Gastric Emptying and Fluid Absorption During and Following Exercise , 1987, Sports medicine.

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

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

[21]  R. Byrd,et al.  The effect of acute thermal dehydration and rapid rehydration on isometric and istonic endurance. , 1979, The Journal of sports medicine and physical fitness.

[22]  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.

[23]  D. Costill,et al.  Rapid fluid replacement following thermal dehydration. , 1973, Journal of applied physiology.

[24]  T M McLellan,et al.  Heat acclimation, aerobic fitness, and hydration effects on tolerance during uncompensable heat stress. , 1998, Journal of applied physiology.

[25]  K. N. Sharma,et al.  Effect of dehydration and a few regimes of rehydration on human performance. , 1980, Indian journal of physiology and pharmacology.

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

[27]  D. Casa.  Exercise in the Heat. II. Critical Concepts in Rehydration, Exertional Heat Illnesses, and Maximizing Athletic Performance. , 1999, Journal of athletic training.

[28]  E. Nadel,et al.  Shift in body fluid compartments after dehydration in humans. , 1988, Journal of applied physiology.

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

[30]  E. Nadel,et al.  Effect of blood volume on forearm venous and cardiac stroke volume during exercise. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[31]  K B Pandolf,et al.  Hypohydration and exercise: effects of heat acclimation, gender, and environment. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[32]  S. Montain,et al.  Carbohydrate-electrolyte solution effects on physical performance of military tasks. , 1997, Aviation, space, and environmental medicine.

[33]  R. Murray,et al.  The effects of beverage carbonation on sensory responses and voluntary fluid intake following exercise. , 1997, International journal of sport nutrition.

[34]  D. Costill,et al.  Carbohydrates for Exercise: Dietary Demands for Optimal Performance , 1988, International journal of sports medicine.

[35]  E R Nadel,et al.  Effect of hydration state of circulatory and thermal regulations. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[36]  C. Gisolfi,et al.  Fluid Homeostasis During Exercise , 1990 .

[37]  C. Willíams,et al.  Influence of carbohydrate supplementation early in exercise on endurance running capacity. , 1996, Medicine and science in sports and exercise.

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

[39]  B. Nielsen,et al.  Thermoregulation in exercising man during dehydration and hyperhydration with water and saline , 1971, International journal of biometeorology.

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

[41]  D. Costill,et al.  Muscle water and electrolytes following varied levels of dehydration in man. , 1976, Journal of applied physiology.

[42]  J. Hoffman,et al.  Thermal and circulatory responses during exercise: effects of hypohydration, dehydration, and water intake. , 1997, Journal of applied physiology.

[43]  R. C. Dennis,et al.  Control of thermoregulatory sweating during exercise in the heat. , 1989, The American journal of physiology.

[44]  D. Riebe,et al.  Intravenous vs. oral rehydration: effects on subsequent exercise-heat stress , 1997 .

[45]  E. Buskirk,et al.  Body fluid balance : exercise and sport , 1996 .

[46]  M. Sawka,et al.  Influence of hydration level and body fluids on exercise performance in the heat. , 1984, JAMA.

[47]  M. Houston,et al.  The Effect of Rapid Weight Loss on Physiological Functions in Wrestlers. , 1981, The Physician and sportsmedicine.

[48]  J. Mitchell,et al.  The influence of volume on gastric emptying and fluid balance during prolonged exercise. , 1991, Medicine and science in sports and exercise.

[49]  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.

[50]  B. Jones,et al.  The Boston Marathon Medical Care Team: Ten Years of Experience. , 1988, The Physician and sportsmedicine.

[51]  P. Thompson,et al.  American College of Sports Medicine position stand. Heat and cold illnesses during distance running. , 1996, Medicine and science in sports and exercise.

[52]  E. Nadel,et al.  Role of cardiopulmonary baroreflexes during dynamic exercise. , 1988, Journal of applied physiology.

[53]  Byrd Rj,et al.  Circulatory responses to submaximal exercise after dehydration and rehydration. , 1976, The Journal of sports medicine and physical fitness.

[54]  Clyde Williams,et al.  Human Muscle Glycogen Metabolism During Exercise Effect of Carbohydrate Supplementation , 1997 .

[55]  Y. Epstein,et al.  Fluid-electrolyte balance during labor and exercise: concepts and misconceptions. , 1999, International journal of sport nutrition.

[56]  J. Greenleaf,et al.  Ion-osmotic hyperthermia during exercise in dogs. , 1976, The American journal of physiology.

[57]  A. Jeukendrup,et al.  Carbohydrate-Electrolyte Feedings Improve 1 h Time Trial Cycling Performance , 1997, International journal of sports medicine.

[58]  P. Leatt,et al.  Effect of glucose polymer ingestion on glycogen depletion during a soccer match. , 1989, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[59]  C. Lambert,et al.  Effects of Carbohydrate Feeding on Multiple-bout Resistance Exercise , 1991 .

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

[61]  J. Kang,et al.  Effect of carbohydrate substrate availability on ratings of perceived exertion during prolonged running. , 1997, International journal of sport nutrition.

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

[63]  D. Nieman.  Influence of carbohydrate on the immune response to intensive, prolonged exercise. , 1998, Exercise immunology review.

[64]  R. Wilber,et al.  Influence of carbohydrate ingestion on blood glucose and performance in runners. , 1992, International journal of sport nutrition.

[65]  M. Sawka,et al.  Fluid Replacement Strategies for Exercise in Hot Weather , 1996 .

[66]  D. Booth.  Influences on human fluid consumption , 1991 .

[67]  C. Gisolfi,et al.  Guidelines for optimal replacement beverages for different athletic events. , 1992, Medicine and science in sports and exercise.

[68]  D. Riebe,et al.  Urinary indices of hydration status. , 1994, International journal of sport nutrition.

[69]  Gary W. Mack,et al.  Position stand on exercise and fluid replacement , 1996 .

[70]  W. Saris,et al.  Effects of dehydration on gastric emptying and gastrointestinal distress while running. , 1990, Medicine and science in sports and exercise.

[71]  O. Bar-or,et al.  Water and electrolyte replenishment in the exercising child. , 1996, International journal of sport nutrition.

[72]  L. Armstrong,et al.  REHYDRATION WITH GLYCEROL: ENDOCRINE, CARDIOVASCULAR, AND THERMOREGULATORY EFFECTS DURING EXERCISE IN 37 ??C , 1998 .

[73]  L. Armstrong,et al.  The Induction and Decay of Heat Acclimatisation in Trained Athletes , 1991, Sports medicine.

[74]  M. Harrison,et al.  Intravascular volume and tonicity as factors in the regulation of body temperature. , 1978, Journal of applied physiology: respiratory, environmental and exercise physiology.

[75]  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.

[76]  R. Hawkins,et al.  Carbohydrate intake and recovery of intermittent running capacity. , 1997, International journal of sport nutrition.

[77]  E. Nadel,et al.  Role of osmolality and plasma volume during rehydration in humans. , 1988, Journal of applied physiology.

[78]  W. Roberts.  Exercise-Associated Collapse in Endurance Events: A Classification System. , 1989, Physician and sportsmedicine.

[79]  B. Jones,et al.  Preparing Alberto Salazar for the Heat of the 1984 Olympic Marathon. , 1986, The Physician and sportsmedicine.

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

[81]  A. Ryan,et al.  Effect of hypohydration on gastric emptying and intestinal absorption during exercise. , 1998, Journal of applied physiology.

[82]  E. Coyle.  Thermal and Cardiovascular responses to fluid replacement during exercise , 1993 .

[83]  G. Skrinar,et al.  Hyperhydration: thermoregulatory effects during compensable exercise-heat stress. , 1997, Journal of applied physiology.

[84]  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.

[85]  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.

[86]  E Hultman,et al.  Effect of temperature on muscle energy metabolism and endurance during successive isometric contractions, sustained to fatigue, of the quadriceps muscle in man , 1972, The Journal of physiology.

[87]  P. Neufer,et al.  Gastric emptying during 1 h of cycling and running at 75% VO2max. , 1991, Medicine and science in sports and exercise.

[88]  G. Pichan,et al.  Effect of primary hypohydration on physical work capacity , 1988, International journal of biometeorology.

[89]  L. Burke,et al.  Body weight changes and voluntary fluid intakes during training and competition sessions in team sports. , 1996, International journal of sport nutrition.

[90]  C. Gisolfi,et al.  Fluid and Carbohydrate Replacement During Intermittent Exercise , 1998, Sports medicine.

[91]  O. Bar-or,et al.  Hypohydration during exercise in children: effect on thirst, drink preferences, and rehydration. , 1994, International journal of sport nutrition.

[92]  B. Marriott.  Environmental Issues That Influence Intake of Replacement Beverages , 1994 .

[93]  R. Rutt,et al.  Physiological effects of a weight loss regimen practiced by college wrestlers. , 1990, Medicine and science in sports and exercise.

[94]  B. Saltin,et al.  Factors limiting gastric emptying during rest and exercise. , 1974, Journal of applied physiology.

[95]  K. Fallon,et al.  Nutritional and fluid intake in a 100-km ultramarathon. , 1998, International journal of sport nutrition.

[96]  D. Casa.  Exercise in the heat. I. Fundamentals of thermal physiology, performance implications, and dehydration. , 1999, Journal of athletic training.

[97]  S. Shirreffs,et al.  Recovery from prolonged exercise: restoration of water and electrolyte balance. , 1997, Journal of sports sciences.

[98]  B. Marriott.  Considerations for Replacement Beverages: Fluid-Electrolyte Balance and Heat Illness , 1994 .

[99]  B. MCARDLE,et al.  Physiology of Man in the Desert , 1948, Nature.

[100]  E G Cummings,et al.  Dehydration and muscular work. , 1966, Journal of applied physiology.

[101]  M. L. Riedesel,et al.  Hyperhydration with glycerol solutions. , 1987, Journal of applied physiology.

[102]  W. Payne,et al.  Rowing performance, fluid balance, and metabolic function following dehydration and rehydration. , 1993, Medicine and science in sports and exercise.

[103]  M. Sawka,et al.  Human tolerance to heat strain during exercise: influence of hydration. , 1992, Journal of applied physiology.

[104]  C. Willíams,et al.  Carbohydrate intake and recovery from prolonged exercise. , 1993, International journal of sport nutrition.

[105]  E. Coyle,et al.  Rehydration after Exercise with Common Beverages and Water , 1992, International journal of sports medicine.

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

[107]  F Sargent,et al.  Voluntary dehydration in man. , 1965, Journal of applied physiology.

[108]  Gary W. Mack,et al.  ACSM Position Stand: Exercise and Fluid Replacement , 1996 .

[109]  N. B. Strydom,et al.  The influence of water restriction on the performance of men during a prolonged march. , 1966, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[110]  L. Armstrong,et al.  Urinary indices during dehydration, exercise, and rehydration. , 1998, International journal of sport nutrition.

[111]  M N Sawka,et al.  Physiological consequences of hypohydration: exercise performance and thermoregulation. , 1992, Medicine and science in sports and exercise.

[112]  S. Shirreffs,et al.  Post-exercise rehydration in man: effects of volume consumed and drink sodium content. , 1996, Medicine and science in sports and exercise.

[113]  E. Nadel,et al.  Body temperature modification of osmotically induced vasopressin secretion and thirst in humans. , 1995, The American journal of physiology.

[114]  P. Gopinathan,et al.  Role of dehydration in heat stress-induced variations in mental performance. , 1988, Archives of environmental health.

[115]  R. Francesconi,et al.  Simultaneous determination of fluid shifts during thermal stress in a small-animal model. , 1986, Journal of applied physiology.

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

[117]  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.

[118]  H. Nose,et al.  Integrative regulations of body temperature and body fluid in humans exercising in a hot environment , 1997, International journal of biometeorology.

[119]  R Murray,et al.  Dehydration, hyperthermia, and athletes: science and practice. , 1996, Journal of athletic training.

[120]  Terjung Rl,et al.  Effects of progressive hypohydration on maximal isometric muscular strength. , 1968 .

[121]  M. Coles,et al.  Dietary Sodium and Plasma Volume Levels with Exercise , 1997, Sports medicine.

[122]  J. Balmer,et al.  Carbohydrate ingestion improves endurance performance during a 1 h simulated cycling time trial. , 1997, Journal of sports sciences.

[123]  R. Pate,et al.  Carbohydrate-electrolyte drinks: effects on endurance cycling in the heat. , 1988, The American journal of clinical nutrition.

[124]  B. Saltin.  CIRCULATORY RESPONSE TO SUBMAXIMAL AND MAXIMAL EXERCISE AFTER THERMAL DEHYDRATION. , 1964, Journal of applied physiology.

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

[126]  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.

[127]  Iampietro Pf,et al.  Relation of climate and temperature to food and water intake in man. , 1958 .

[128]  D. Costill,et al.  Influence of diuretic-induced dehydration on competitive running performance. , 1985, Medicine and science in sports and exercise.

[129]  L. C. Senay.  Temperature regulation and hypohydration: a singular view. , 1979, Journal of applied physiology: respiratory, environmental and exercise physiology.

[130]  J. Greenleaf,et al.  Problem: thirst, drinking behavior, and involuntary dehydration. , 1992, Medicine and science in sports and exercise.

[131]  J. Hellemans,et al.  The effect of glycerol and desmopressin on exercise performance and hydration in triathletes. , 1998, Medicine and science in sports and exercise.

[132]  D. Booth,et al.  Thirst: Physiological and Psychological Aspects , 1991 .

[133]  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.

[134]  T P Garigan,et al.  Death from hyponatremia as a result of acute water intoxication in an Army basic trainee. , 1999, Military medicine.

[135]  E. Coyle,et al.  Reversal of fatigue during prolonged exercise by carbohydrate infusion or ingestion. , 1987, Journal of applied physiology.

[136]  W. Bartoli,et al.  Gastric emptying and plasma deuterium accumulation following ingestion of water and two carbohydrate-electrolyte beverages. , 1997, International journal of sport nutrition.

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

[138]  U. Nousiainen,et al.  Differential effects of sauna-, diuretic-, and exercise-induced hypohydration. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.

[139]  S. Flanagan,et al.  Effects of carbohydrate type and concentration and solution osmolality on water absorption. , 1995, Medicine and science in sports and exercise.

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

[141]  M. Jobin,et al.  Effects of Carbohydrate Intake before and during an Ice Hockey Game on Blood and Muscle Energy Substrates , 1988 .

[142]  E. Coyle,et al.  Carbohydrate feeding during prolonged strenuous exercise can delay fatigue. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[143]  S. Permutt,et al.  Effect of exercise hemoconcentration and hyperosmolality on exercise responses. , 1988, Journal of applied physiology.

[144]  M. Sawka,et al.  Aerobic fitness and the hypohydration response to exercise-heat stress. , 1984, Aviation, space, and environmental medicine.

[145]  T. Noakes,et al.  The effect of a preexercise meal on time to fatigue during prolonged cycling exercise. , 1999, Medicine and science in sports and exercise.

[146]  D. Kleiner,et al.  Medical considerations and planning for short distance road races. , 1994, Journal of athletic training.

[147]  R. Hubbard,et al.  Symptomatic hyponatremia during prolonged exercise in heat. , 1993, Medicine and science in sports and exercise.

[148]  H. Nose,et al.  Distribution of water losses among fluid compartments of tissues under thermal dehydration in the rat. , 1983, The Japanese journal of physiology.

[149]  R. Murray.  Nutrition for the marathon and other endurance sports: environmental stress and dehydration. , 1992, Medicine and science in sports and exercise.

[150]  C. Gisolfi,et al.  Effects of cycle exercise on intestinal absorption in humans. , 1991, Journal of applied physiology.

[151]  L. Armstrong.  Performing in Extreme Environments , 1999 .

[152]  E. Adolph,et al.  Physiology of Man in the Desert , 1969 .

[153]  D. Costill,et al.  Heat tolerance following diuretic induced dehydration. , 1976, Medicine and science in sports.

[154]  W. Roberts,et al.  Team Sports in Hot Weather: Guidelines for Modifying Youth Soccer , 1991 .

[155]  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.

[156]  P M Vanderburgh,et al.  Periodic carbohydrate replacement during 50 min of high-intensity cycling improves subsequent sprint performance. , 1995, International journal of sport nutrition.

[157]  C. Gisolfi,et al.  Fluid balance for optimal performance. , 2009, Nutrition reviews.

[158]  J. S. Bosco,et al.  Effects of progressive hypohydration on maximal isometric muscular strength. , 1968, The Journal of sports medicine and physical fitness.

[159]  M. Luetkemeier,et al.  Hypervolemia and cycling time trial performance. , 1994, Medicine and science in sports and exercise.

[160]  C. Horswill.  Applied Physiology of Amateur Wrestling , 1992, Sports medicine.

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

[162]  J. Greenleaf,et al.  Exercise temperature regulation in man during hypohydration and hyperhydration. , 1971, Journal of applied physiology.

[163]  R. Serfass,et al.  The Effects of Rapid Weight Loss and Attempted Rehydration on Strength and Endurance of the Handgripping Muscles in College Wrestlers , 1984 .

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

[165]  G. Rogers,et al.  Water budget during ultra-endurance exercise. , 1997, Medicine and science in sports and exercise.

[166]  T. Noakes,et al.  Carbohydrate, fluid, and electrolyte requirements of the soccer player: a review. , 1994, International journal of sport nutrition.

[167]  M. El-sayed,et al.  Effects of carbohydrate feeding before and during prolonged exercise on subsequent maximal exercise performance capacity. , 1995, International journal of sport nutrition.

[168]  M. L. Riedesel,et al.  Pre-Exercise Glycerol Hydration Improves Cycling Endurance Time , 1996, International journal of sports medicine.

[169]  D. H. Card,et al.  Effects of acute dehydration and starvation on muscular strength and endurance. , 1974, Acta physiologica Polonica.

[170]  M. Sawka,et al.  Hypohydration effects on skeletal muscle performance and metabolism: a 31P-MRS study. , 1998, Journal of applied physiology.

[171]  H. Schedl,et al.  Simultaneous Determination of Gastric Emptying and Intestinal Absorption During Cycle Exercise in Humans , 1996, International Journal of Sports Medicine.

[172]  E. Nadel,et al.  Exercise, Heat, and Thermoregulation , 1993 .

[173]  S. Shirreffs,et al.  Factors influencing the restoration of fluid and electrolyte balance after exercise in the heat. , 1997, British journal of sports medicine.

[174]  R. Murray.  Fluid needs in hot and cold environments. , 1995, International journal of sport nutrition.

[175]  O. Bar-or,et al.  Consistency in preventing voluntary dehydration in boys who drink a flavored carbohydrate-NaCl beverage during exercise in the heat. , 1998, International journal of sport nutrition.

[176]  K B Pandolf,et al.  Thermoregulatory and blood responses during exercise at graded hypohydration levels. , 1985, Journal of applied physiology.

[177]  D. E. Bass,et al.  Effects of overhydration on man's physiological responses to work in the heat , 1965 .

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

[179]  O. Bar-or,et al.  Fluid and Electrolyte Loss During Exercise , 1994 .