Exercise hydration- knowledge, impact and education

Tuesday 6 October 2020; 10 am-12 noon

1. Importance, tropical climate, population type (old, young, athletes) &
drink types
2. Exercise hydration knowledge before during & after training, exercise or
sport
3. Hydration & endurance performance in adult athletes
4. Discussion points & interaction session with Q & A
Thermoregulation & heat management in exercise

Professor Michael Chia

Basic thermodynamics of heat gain & loss

Heat gain by body

Exercise generates metabolic heat
Radiant heat from sun
Radiant heat from ground by convention & conduction

 Heat loss by body

 Cooling by evaporation
 Radiation
 Convection

Rate of heat loss depends on temperature gradient,

velocity of wind & ambient humidity
What is the best heat management strategy?

1. Increase aerobic fitness

2. Heat acclimatisation
3. Pre-exercise cooling
4. Reduce work-rest cycle
5. Hydration
Hydration & performance of adult athletes- half maranthon

Professor Michael Chia

 Half marathon individual sweat rates (n=31)
2.5
(1) Physical fitness and heat acclimation status

2.0 (2) Amount and type of clothing worn

Sweat Rate (l/h)

1.5

1.0 (3) Exercise intensity

(4) Climatic conditions

0.5
0 5 10 15 20 25 30 35
Finishing Position
Lee et al. (2010). EJAP
 In well trained & super-fit soldiers
2.5 Fluid loss > replacement

2.0

1.5
Sweat Rate
L/h

1.0

0.5
(~20%
Fluid Intake
replacement)
0.0
0 5 10 15 20 25 30 35
Finishing Position
Lee et al. (2010). EJAP
Thirst for more- before, during and after exercise
Exercise hydration knowledge of Singporeans
(PE teachers, sport coaches & athletes)

Professor Michael Chia

Geographically, we are in the hot zone of weather

Equator

Hot & high humidity

Youth and sports
1. Physical education and co-curricular activities
- Holistic development of Singaporean youth
2. More than 500 000 school-going youth
-aged 7 to 18 years
- Mandatory PE lessons up to 180 min per week
- Outdoor co-curricular activities
3. Hot and humid weather conditions
- Throughout the year
Youth and sports
Youth participation in sports
- Exponential rise
- Hosting of mega sports events

Youth population at risk of heat disorders

-On the rise (though deaths are rare)
-Many heat ailments are not reported

Need to formalize
- Preventive education & guidelines
- Especially related to dehydration
Hydration in youth
Negative effects of dehydration
Greater than 2% loss of body weight
- increased physiological strain
- reduced exercise performance
- affect thermoregulation
- affect acclimatization
Dehydration in high-school adolescents
Loss of match and practice time in five major sports (Power et al, 2000)

In Singapore
Lack of data on hydration knowledge and practices
Hydration in youth
All athletes need adequate hydration
- Maintain peak performance
- Prevent heat disorders

Both children and adults – similar behaviour

- Inadequate hydration
- Despite fluid availability
- Voluntary dehydration
Hydration knowledge of sport professionals
Youth athletes
- Rely on coaches & PE teachers
- Hydration knowledge and fluid replacement

Hydration knowledge of sport professionals in Singapore

- Sporadic and unclear
Research purpose
Examine exercise hydration knowledge in youth coaches and physical
education teachers in Singapore
Methodology
Participants
Institution ethics clearance (NIE & SSC) &
Written informed consent given by participant

Coaches (n=193)
- Beginning coaches (n=129)
- Certified coaches (n=64)

Physical Education teachers (n=164)

- Beginning teachers (n=102)
- Graduating teachers (n=62)
Established validity & reliability of questionnaire
Based upon position statements of three international exercise, training &
sport organizations
- American College of Sports Medicine (USA)
- National Athletic Trainers Association (USA)
- American Pediatric Association (USA)

Content validity established by

- Two certified exercise physiologists (UK) + 1 sport nutritionist (USA)

Reliability established as
Cronbach’s α – 0.779
Hydration Knowledge Quiz
Hydration & fluid replacement statements

Part -1: Demographic information

Qualifications
Source of knowledge
Youth coaching

Part -2: Hydration knowledge quiz

Before, during & after exercise

Adequate hydration knowledge

≥ 80% score (Singapore Red Cross)
By taking the quiz, you give consent for the results to be used as
research led by UPI, PI- Dr Ronald Hamidie & Prof Michael Chia

 The 31-item quiz (answer True or False) will take 10 minutes to complete
 Only grouped data to be used for presentation & publication basis
 All data are anonymous and there are no personal identifiable data
 There are no perceived harm in taking the quiz
 The benefit is that you will get a feedback on your total score for the quiz on
exercise hydration knowledge
 Thank you for your kind participation in the research
Take 10 minutes to complete the exercise hydration questionnaire

Please scan & complete survey

Slido time…pause to take questions or check comments posted
about the exercise hydration knowledge quiz
 Results
Of Singapore study
 Description of participants
40 37.7 90%
Age in yrs 80%
75% 77%
80%
35 69%
29.2 28.6 70%
30 27.5
60%
25 Sex
50%
20 Male
40% 31%
15 Female
30% 25% 23%
20%
10 20%
5 10%
0 0%
Begn Coaches Cert Coach Begn Teachers Grad Teachers Begn Coaches Cert Coaches Begn Teachers Cert Teachers

Professional experience in coaching youths

No Exp <2 yr 2-5yr 6-10 yr >10yr
Beginning Coaches 0% 61% 19% 8% 5%
Certified Coaches 0% 30% 37% 15% 18%
Beginning Teachers 30% 46% 20% 4% 0%
Certified Teachers 18% 65% 11% 6% 0%
Exposure to coaching youths & professional qualifications
100% 120
Coaching youth athletes
78% 100
80% 72% 71% Qualifications
63% 80
60%
Formal
60
Self study/Internet
40%
40 Experience

20% 20

0% 0
Begn Cert Begn Cert Begn Cert Coaches Begn Cert
Coaches Coaches Teachers Teachers Coaches Teachers Teachers
Characteristics of sport professionals
Source of hydration knowledge Type of sport coached

80%
70% 70%
70%
63%
58%
60%

50%
Lec/Wksp
40% Internet
30% Print

20% Others

10%

0%
Begn Cert Begn Cert
Coaches Coaches Teachers Teachers
Quiz performance
90%

80% Passing mark

70% 68.09% 67.01%

61.76% 62.46%
60%

50%

40%
Begn Coaches Cert Coaches Begn Cert Teachers
Teachers

Mean scores
 Pass or fail
80%
74.00%

60.90% 60.10%
60% 56.00%

40%
Begn Coaches Cert Coaches Begn Teachers Cert Teachers

Mean scores of youth coaches Pass or fail

Discussion
Noteworthy
Questions most coaches did not attempt
- Whether drinking slowly helps body retain fluids better?
- Whether drinks containing electrolytes (e.g. sodium) helps body retain fluids better?
- Whether diet drinks are ideal choice for fluid, energy replenishment and to prevent
electrolyte imbalance during training/competition?

Questions most coaches were unsure of

- Overconsumption of fluids  Exercise associated hypo-antremia
- Symptoms of water intoxication – confusion, nausea, fatigue & seizures
- % of fluid lost to be consumed within 24 hours
 Inadequate hydration knowledge among coaches
Adequate hydration knowledge
-28 of 357 coaches (7.8% attained 80% or above)
-22 of 251 youth coaches (8.7% attained 80% or above)

Youth are dependent on coaches for such knowledge

Knowledge inadequacy on exercise hydration knowledge amongst coaches

Insufficient and inaccurate hydration information to athletes

Implications on coach education and development programmes

Does certification matter?
Coaching certification
- Marginal effect on hydration knowledge

Certified PE teachers
- Knowledge of exercise physiology
- Minimal impact on hydration & fluid replacement knowledge

Implications on safety during PE and CCA

Knowledge sources
Hydration knowledge
- Lectures/workshops/seminars
- Internet
- Print sources (e.g. magazines)

Need to educate sport professionals

- Select credible knowledge resource
Summary 1
Remediation through specific exercise
hydration education

After exercise
hydration knowledge
particularly lacking
EXERCISE
Exercise hydration knowledge gaps
Slido time…pause to take questions or check comments posted
Summary 2
National Youth Sports Institute exercise hydration tips

https://youtu.be/3iZyBmWciyo https://youtu.be/cvqm5MfmNiw
Before Exercise
Goal : Commence euhydrated with normal electrolyte level

1. Drink slowly (~~5–7 ml/kg

BM) ~ 4 h before event

2. Continue drinking (3-5 ml/kg

BM) if no urine is produced,
or the urine is dark or highly
concentrated

ACSM Position Stand (2007)

 SIMPLE HYDRATION CHECK

Likely
Body Urine
Mass
< 1%
Very
Likely

Likely Likely

Thirst
GSSI Sports Science Exchange #97
After Exercise
Goal : To replace any fluid and electrolyte deficit

1. Drink ~1.5 L of fluid for each kg of BM lost

2. Aggressiveness depends on:

 the speed that rehydration must be accomplished
 the magnitude of the fluid-electrolyte deficit

3. Consumed over time to maximize fluid retention

ACSM Position Stand (2007)

Singapore research
 Heat management

Lengthening work tolerance

Extension
Max. limit

Expanding heat capacity

Heat Strain
Attenuation
( degC)
Start state

37
36.5 Reduction

Work Tolerance
(time) Alhadad et al. (2019); Front. Physiol.
 5 Heat Management Strategies
AEROBIC FITNESS HEAT PRE-ACTIVITY WORK REST HYDRATION
CONDITIONING ACCLIMATIZATION COOLING CYCLES

Reduction Reduction Reduction Reduction Attenuation

Attenuation Attenuation Attenuation

Extension

Alhadad et al. (2019); Front. Physiol.

Personal wisdom
I drink only on two occasions…

When I am thirsty

&

When I am not
Colour you & colour me- check your colour & volume often

High volume
of urine

Low volume
of urine
Learner satisfaction scale- I value your feedback

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