FLUID REPLACEMENT

BEFORE, DURING AND

AFTER EXERCISE

Introduction:
Water is the primary
constituent by weight and
volume of the human
body.
An 80-kg man contains
about 53 L of water
comprising 66 % of the
body weight.

Introduction - Fluid balance

High rate of metabolic
must be balanced by
an equal heat loss to
maintain core
temperature.
In warm weather, the
only avenue of heat
lost is by evaporation
of sweat from skin.

Heat Illnesses
Represent a continuum of disorders that
may range from the somewhat irritating to
perhaps one of the most dramatic of
medical emergencies, ranging intensity and
severity from mild CV and central NS
disturbances, such as hypotension and
fainting, to profound cellular damage, such
as the characteristic brain, kidney, liver, and
blood clotting abnormalities of heatstroke.

Heat illness throughout history

1967 During Egypt-Israel Six Day War, an
estimated 20,000 Egyptian lost their lives
due to heat stroke .
1991 Desert Storm, US troops proven
strategies that adopted from Israel.
Dryfuss (1991), Phys Sports Med

2003 3 Fatal report among our school

children throughout their schools sport
activities

Heat Illness
Third leading cause of death in young athletes
Farrel (1980), West J Med

Athletes gain heat from the environment as well as

from muscle work.
Participation in sports during hot, humid weather
makes them particularly susceptible to heat
illness.
Children and adolescents are most susceptible to
heat illness because they have a greater ratio of
surface area to the body mass.

How Body Produce Heat

BMR alone could increase body temp.
1.1C/hour without any mechanism of dissipate.
Hard work can increase body temp. 5C/hour and
strenous exercise through sports may increase by
10 20 fold Robertshaw (1983)
Studies in runners have shown that dehydration
alone elevatebody and core temp up to 40C.
For increase of 1C of core temp.will increase 13%
of cellular metabolism

Heat Dissipation
Through 4 mechanisms:
Radiation , convection, conduction and
evaporation.
When the ambient temp. exceeds body temp.
however, evaporation of sweats is the dominat
mechanism for heat loss, up to 95% of body
cooling.
Each 1.7 ml of sweat evaporated, the body loses 1
kcal of heat.
The lost of body water through sweat will lead to
dehydration

Percent of Body Weight Loss

Adverse effects of dehydration

Thirst threshold, and threshold for impaired exercise
thermoregulation leading to decrement in physical and cognitive
work capacity
Stronger thirst, vague discomfort and sense of
oppression, loss of appetite.
Dry mouth, increasing hemoconcentration, reduction in
urinary output.
Decrement of 20-30 % in physical work capacity.
Difficulty in concentrating,headache,impatience,
sleepiness.
Severe impairment in exercise temperature regulation, increased
respiratory rate Leading to tingling and numbness of extremities
Likely collapse if combine with heat and
exercise
( Greenleaf et al., 1986)

The state of daily body water

Euhydration

tio
ra
yd
eh
D

Hyperhydration

Re
hy
dra
tio
n

ion
at
dr
hy
De

Hypohydration

Body water,% body mass

Extracellular water
Plasma water
Interstitial water
Cellular water
Total water

= 23 L ( 29 % body
= 4 L ( 5 % body
= 19 L ( 24 % body
= 30 L ( 37 % body
= 53 L ( 66 % body

wt.)
wt.)
wt.)
wt.)
wt.)

Daily euhydration variability of total body water :

Temperate conditions = 0.165 L ( 0.22% body wt.)
Heat and exercise conditions = 0.382 L ( 0.48% body wt.)

Daily plasma volume variability = 0.027 L ( 0.6 % blood volume)

Figure 1- Body hydration terminology diagram, and fluid
compartment volumes and variability.
( Greenleaf,J.E.et al., 1986. Nutrition and Aerobic
Exercise,p.107-124r)

Body Fluid State

Prior dehydration will impair the
capacity to perform high intensity
exercise as well as endurance
activities and cognitive.
Prolonged exercise, which resulted in
a loss to fluid corresponding to 2.5% of
body weight, resulted in a 45% fall in
the capacity to perform HIE
Nielsen et al (1982); Armstrong et al (1985)

During sustained exercise in heat, 1 - 2 L/h

of water may be lost as a result of
sweating.
Sawka
and Pandolf (1990)

Body Fluid State

World Cup 2002 Denmark players lost up
to 4 L after 90-minutes of game.
Light exercise will lost 1 L for 1 hour perform
and become to 3L if intensity is increase.
Research showed Athlete still in
dehydrated instead of drinking during
exercise.

Insensible
0.35L/d

Sweat
0.5 12 L/d

Feces
0.1 0.2 L/d

Respiratory loss
0.25 0.35 L/d

Urine
1 1.5 L/d

Routes of fluid loss from the human body.

Range of values from McArdle, Katch & Katch (1986)

At dehydrated state:

Thermoregulation impaired:
Increased heart rate followed by high utilized glycogen
spared.
Impaired performance due to heart rate and deplete
glycogen induced exercise.
Increased body core temperature to induced premature
fatigue. (Maughan, 1999.)

Effects of fluids on performance

Type of drinks Time to
exhaustion (min)
No drink

70.2

Plain water

86.2

Glucose

89.2

Fructose

65.6

maltodextrose 90.8
Exercise at 70% of VO2max
Source: Maughan et al., 2000

Hydration Strategies
Optimising fluid
replacement
Fate of ingested fluid
depends on:
- gastric emptying
the rate gastric emptying
of liquids is influence by :
volume, energy density,
osmolality and stress
- intestinal absorbtion

Before Exercise
Body should be maintained
at euhydrated state:
CHECK URINE COLOUR

Drink water prior to exercise.

Within 2 hours before
COMPETITION drinks 500 ml.
(ACSM, 1996)

Everybody should be encouraged

to monitor urine colour. Darker
colours indicate an inadequate
fluid intake.
Source: Urinary indices of hydration status
(1994). Int J Sport Nutrition.

During exercise:
Drink water 600 1200 ml
per hour
If exercise finished less
than hour, plain water are
sufficient.
If exercise longer than
hour, electrolyte, CHO
beverage should be
concerned.
Practice : 3ml per kg body
weight per hour for every
15 20 minutes.
(ACSM, 1996)

Fluid replacement after exercise.

The most important part
for performance concern
Minimum 150% of losing
during exercise should
be replaced.
Water are not suitable
Concern for electrolyte
drink that contains:
CHO, Na, K for
replacement.

Effects of electrolytes on PV

Ishak et al., (2002)

Fluid ingestion during

recovery
Characteristic of the rehydration fluid may impact the
volume of fluid consumed. (Hoswill,1998)
1. Palatability includes flavor, taste, mouth feel
temperature will influence the fluid consumed.

and

The greater the volume consume, the less

chance that dehydration will develop.
2. Absorption How quickly a fluid empties from
the
stomach that depend on concentration and

type of CHO, sodium presence and osmolality of

the fluid.

Fluid ingestion during recovery

3. Electrolyte content The presence of
electrolytes in a fluid can impact voluntary
intake. The most critical electrolyte
concern
is sodium.
4. Ergogenic benefit While having ergogenic
benefit does not directly stimulate
drinking, the knowledge that a beverage
can enhance performance may promote
the athlete to consume a particular fluid.

Characteristic of the drinks

Sedap
Suhu antara 4 - 15C kerana cepat
pengosongan perut dan membantu dalam
pelepasan oksigen.
Kandungan gula tidak melebihi 6%
Mengandungi electrolyte

Ingat!
Jangan berlengah mengambil
minuman atau makanan sebaik
sahaja selesai menjalani latihan.
Elakan minuman yang
mengandungi caffein dan alkohol

There is no single formulation

Conclusion
Fluid maintained throughout exercise:
Increased resting plasma volume and maintained .
Can maintained sweat rate as mechanism for
thermoregulation.
(1C increased in core temperature followed by
increased HR for 30 bps respectively.
Better maintenance of body temperature is
achieved at the expense of increased sweat loss.