Nutrition Marie Dunford
J. Andrew Doyle
for Sport and Exercise, Third Edition
7 Water and Electrolytes
© Cengage Learning 2015
Learning Objectives
• Outline strategies for maintaining fluid balance
before, during, and after exercise, explain the
phenomenon of hyponatremia, and outline a
strategy for its prevention in endurance and
ultraendurance athletes
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• Requirement of thermoregulation is important .
• Hyperthermia can be fatal
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7.1 Overview of Water and Electrolytes
• Water is the most important nutrient
• 60% of adult body weight is water
• Too great a water loss is detrimental to
performance and health
• Electrolyte balance is important
• Each athlete must have an individualized plan
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Overview of Water and Electrolytes
• Water volume
– Euhydration
• Dehydration
• Hyperhydration
• Hypohydration
• Osmosis
• Tonicity
– How to affect hydration?
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Overview of Water and Electrolytes
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The Amount of Water in the Body
Depends on Many Factors
• Factors
– Body size
• Larger people have more body water
– Gender
• Males have more body water
– Age
• Younger adults have more body water
– Body composition
• Leaner individuals have more body water
• Average amounts
– 42 L (70 kg male); 30 L (female)
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The Amount of Water in the Body
Depends on Many Factors
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The Amount of Water in the Body
Depends on Many Factors
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7.2 Water Loss, Intake, Balance, and
Imbalance
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Water Loss, Intake, Balance, and
Imbalance
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Water is Lost in a Variety of Ways
• Insensible
– Ventilation
– Non-sweat diffusion through the skin
• Sensible
– Feces
• Average daily loss is ~100 ml
– Urine
• Major mechanism for controlling fluid balance
• ~1,500 ml daily
• Affected by fluid and sodium intake, hormones,
and diuretics
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Sensible Water Loss
• Sweat
– Water that is secreted from sweat glands onto the
surface of the skin
– Varies considerably from ~100 ml
– Sweating is usually visible but also occurs when
exercising in the water
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The Addition of Water to the Body
• Primarily through fluid content of beverages and
foods
• Secondarily through metabolism
• Average daily intake is ~2,350 ml but varies
considerably
• Water from metabolism contributes ~350 ml
daily
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There Are Constant Changes in Body
Water
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Hypohydration, Euhydration, and
Hyperhydration
• Euhydration
– A “normal” amount of water to support fluid
balance and to easily meet required physiological
functions
– This optimal level of hydration is typically
achieved by consuming fluids in excess of need
and allowing the renal system to excrete the
unneeded amount
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Hypohydration, Euhydration, and
Hyperhydration
• Hyperhydration
– Body water above that considered normal and is
typically a short-term condition
– Renal system responds by increasing urine
output
– Dilutes the concentration of solutes in the
extracellular fluid
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• Hypohydration Hypohydration, Euhydration, an
– Body fluid level below normal
Hyperhydration
– Inadequate intake, excessive loss or both
– Water loss from ECF causes water to shift from
cells to ECF
– Cell function is impaired
– Affects performance and health
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Sodium Intake and Excretion
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7.3 Effect of Exercise on Fluid Balance
• Under normal conditions, fluid balance is easily
regulated
• Exercise challenges fluid homeostasis
– Increases body temperature
– Increases fluid loss via sweating
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Complications fuid imabalance
• Sodium and potassium loses from the body
• PEES
• n athlete, you can lose as much as 3 L (3 qt) of
fluid an hour during an intense workout. Fluid
loss in endurance activities such as distance
running, cycling, strenuous hiking, or cross-
country skiing can be severe. These types of
activities can quickly lead to heat exhaustion.
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• In endurance athletes, dehydration can
cause symptoms, called post-extreme
endurance syndrome (PEES).
• Symptoms of PEES include decreased body
temperature, nausea, vomiting, diarrhea,
dizziness, headache, muscle cramps, and
an inability to drink fluids.
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Exercise Can Have Dramatic Effects on
Water Loss
• Decrease in plasma volume shortly after
exercise begins
– Some fluid leaks from plasma into the interstitial
spaces
– Small losses (~5%) typically do not impair
performance
– Large losses (~10-20%) may reduce performance
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Exercise Can Have Dramatic Effects on
Water Loss
• Increase in sweating
– Critical mechanism to prevent excessive increase
in body temperature
– Influential factors
• Exercise intensity
• Environmental conditions
• Clothing
• Training status
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Amount of Sweat Lost During Exercise
• Sweat loss can vary considerably
– ~100 ml daily in non-exercise, temperate
conditions
– ~300 to 1,200 ml/hr if exercising in high
temperatures
– ~1 to 2 L/hr if exercising in high temperatures
with protective clothing
– In excess of 2.5 L/hr in prolonged exercise in the
heat
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Amount of Sweat Lost During Exercise
• Sweat rate calculation:
• Pre-training weight = 75kg
• Post-training weight (before showering & dry off any excess
sweat) = 73kg
• Change in body weight = 2kg
• Fluid intake during training = 1 litre
• Training duration = 2 hours
• Calculations:
• Fluid loss (L) = pre-weight (75kg) – post-weight (73kg) =
2kg
• Total sweat loss (L) = change in weight (2kg) + fluid intake
(1L) = 3kg
• Sweat rate (L/hr) = total sweat loss (3kg) ÷ training
duration (2hrs) = 1.5 L/hr
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Amount of Sweat Lost During Exercise
• This heavily favored Olympic marathoner was
unable to finish the race, which was held in hot
and humid conditions
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Electrolyte Loss During Exercise Can Be
Substantial
• Losses of sodium and chloride greatest
• Electrolyte replacement if exercising more than
two hours
• Sodium replacement along with carbohydrate
intake
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Exercise-Related Muscle Cramping
• Widely believed but unfounded that dehydration
and electrolyte loss cause of EAMC
• May be a result of non-nutritional causes
• Heat cramps
– Total body cramping when exercising in the heat
– May be a result of rapid and large fluid and
sodium losses
– Individualized plan for sodium and fluid during
and after exercise is needed
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Hydration Status Should Be Assessed
and Monitored
• Precise measurements
– Plasma osmolarity
– 24-hour urine collection
• Urine analysis
– Measurement of specific gravity and osmolarity
– Subjective analysis of urine color
– Practical, less expensive, and/or reasonably
accurate
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Hydration Status Should Be Assessed
and Monitored
• Acute changes in body weight
– 1 L of water lost = ~1 kg (2.2 lb)
– Tracking daily weight
– Tracking pre- and post-exercise weights
– Not recommended for use with those struggling
with disordered eating
• Simple hydration assessment tool
– Weight loss
– Thirst
– Urine color
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Hydration Status Should Be Assessed
and Monitored
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• Urine color chart
• A urine color chart can be used as a general assessment of
• hydration status. A urine sample collected the first thing in the
• morning can be viewed against a white background in good light
• and the color compared to the chart. A lighter urine color in the
• 1, 2, or 3 range can be considered well hydrated, whereas a
• darker urine color in the 6, 7, or 8 range can be considered hypo
hydrated.
• Other factors, such as the use of medications or vitamins,
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Type, Timing, and Amount of Fluid and
Electrolyte Intake
• Individualized plan
• Plan must be tested during training under
various environmental conditions
• Plan may differ from training due to stress of
competition
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Intake Prior to Training and Performance
• Practical issues
– Plan must be individualized
– 17 to 20 ounce fluid before 2 to 3 hours of
exercise
– Gastrointestinal distress is a potential problem
– Account for and adjust to the stress of
competition
– CHO may be included in beverages for
endurance athletes
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Intake During Training and Performance
• Goals are to replace fluid lost and maintain fluid
balance if possible
• 5 to 8 % of carbohydrate –electrolytes beverage will help to reduce
heat
• Endurance athletes required 650to 1250ml of beverage that
contain 4-8% of CHO
– Delaying dehydration to the extent possible
– Avoiding the overconsumption of water
– Replacing sodium if losses are large or rapid
– Consuming carbohydrate if appropriate
– Avoiding gastrointestinal upset
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Intake During Training and Performance
• Individualized plan must consider:
– Sweat rate and composition of sweat
– Duration of exercise
– Clothing and environmental conditions
– Potential dangers of water overconsumption and hyponatremia
– Practical issues
• Cool fluids are typically better tolerated
• Small amounts are typically better tolerated
• Account for and adjust to the stress of competition
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Intake During Training and Performance
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Replenishment After Training and
Performance
• Restoring lost body water to achieve
euhydration
• Aproximatley 8 ounce of fluid after 30 minutes of
exercise
• Replacing sodium and other electrolytes lost
• Consuming adequate carbohydrate to fully
restore muscle glycogen
• Consuming adequate protein to build and repair
skeletal muscle
• Avoiding gastrointestinal upset
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Replenishment After Training and
Performance
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Replenishment After Training and
Performance
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Action Plan
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Action Plan
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In the Process of Replenishing Fluids
and Electrolytes
• Other nutrient are consumed
• Energy (kcal) content
• CHO content (g)
• CHO source
• CHO concentration (%)
• Electrolyte content (mg)
• Caffeine content (mg)
• Inclusion of other compounds (glycerol, herbs,
etc.)
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Hyponatremia
• Plasma sodium concentration less than 135
mmol/L
• Very serious when drop is rapid and
concentration is less than 130 mmol/L
• May result in confusion, seizures, coma, and
death
• Endurance and ultraendurance athletes at risk
• Keys to prevention:
– Avoid overconsumption of water
– Replace sodium lost in sweat
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