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      National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

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          Abstract

          <div class="section"> <a class="named-anchor" id="st1"> <!-- named anchor --> </a> <h5 class="section-title" id="d7115793e206">Objective: </h5> <p id="d7115793e208">To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals. </p> </div><div class="section"> <a class="named-anchor" id="st2"> <!-- named anchor --> </a> <h5 class="section-title" id="d7115793e211">Background: </h5> <p id="d7115793e213">Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals. </p> </div><div class="section"> <a class="named-anchor" id="st3"> <!-- named anchor --> </a> <h5 class="section-title" id="d7115793e216">Recommendations: </h5> <p id="d7115793e218">Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity. </p> </div>

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          Most cited references177

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          National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

          To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation.
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            Urinary indices of hydration status.

            Athletes and researchers could benefit from a simple and universally accepted technique to determine whether humans are well-hydrated, euhydrated, or hypohydrated. Two laboratory studies (A, B) and one field study (C) were conducted to determine if urine color (Ucol) indicates hydration status accurately and to clarify the interchangeability of Ucol, urine osmolality (Uosm), and urine specific gravity (Usg) in research. Ucol, Uosm, and Usg were not significantly correlated with plasma osmolality, plasma sodium, or hematocrit. This suggested that these hematologic measurements are not as sensitive to mild hypohydration (between days) as the selected urinary indices are. When the data from A, B, and C were combined, Ucol was strongly correlated with Usg and Uosm. It was concluded that (a) Ucol may be used in athletic/industrial settings or field studies, where close estimates of Usg or Uosm are acceptable, but should not be utilized in laboratories where greater precision and accuracy are required, and (b) Uosm and Usg may be used interchangeably to determine hydration status.
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              Urinary indices during dehydration, exercise, and rehydration.

              This investigation evaluated the validity and sensitivity of urine color (Ucol), specific gravity (Usg), and osmolality (Uosm) as indices of hydration status, by comparing them to changes in body water. Nine highly trained males underwent a 42-hr protocol involving dehydration to 3.7% of body mass (Day 1, -2.64 kg), cycling to exhaustion (Day 2, -5.2% of body mass, -3.68 kg), and oral rehydration for 21 hr. The ranges of mean (across time) blood and urine values were Ucol, 1-7; Usg, 1.004-1.029; Uosm, 117-1,081 mOsm x kg-1; and plasma osmolality (Posm), 280-298 mOsm x kg-1. Urine color tracked changes in body water as effectively as (or better than) Uosm, Usg, urine volume, Posm, plasma sodium, and plasma total protein. We concluded that (a) Ucol, Uosm, and Usg are valid indices of hydration status, and (b) marked dehydration, exercise, and rehydration had little effect on the validity and sensitivity of these indices.
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                Author and article information

                Journal
                Journal of Athletic Training
                Journal of Athletic Training
                Journal of Athletic Training/NATA
                1062-6050
                September 2017
                September 2017
                : 52
                : 9
                : 877-895
                Article
                10.4085/1062-6050-52.9.02
                5634236
                28985128
                965341d6-bd47-47e6-ab99-7ce46e5933a0
                © 2017
                History

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