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Proper
Hydration
Exercise and Fluid Replacement
From Elizabeth Quinn,
The American College of Sports Medicine Position Stand
It is the position of the American College of Sports Medicine that adequate
fluid replacement helps maintain hydration and, therefore, promotes the
health, safety, and optimal physical performance of individuals participating
in regular physical ctivity. This position statement is based on a comprehensive
review and interpretation of scientific literature concerning the influence
of fluid replacement on exercise performance and the risk of thermal injury
associated with dehydration and hyperthermia.
Based on available evidence, the American College of Sports Medicine makes
the following general recommendations on the amount and composition of
fluid that should be ingested in preparation for, during, and after exercise
or athletic competition:
1. It is recommended that individuals consume a nutritionally balanced
diet and drink adequate fluids during the 24-hr period before an event,
especially during the period that includes the meal prior to exercise,
to promote proper hydration before exercise or competition.
2. It is recommended that individuals drink about 500 ml (about 17 ounces)
of fluid about 2 h before exercise to promote adequate hydration and allow
time for excretion of excess ingested water. During exercise, athletes
should start drinking early and at regular intervals in an attempt to
consume fluids at a rate sufficient to replace all the water lost through
sweating (i.e., body weight loss), or consume the maximal amount that
can be tolerated.
3. It is recommended that ingested fluids be cooler than ambient temperature
[between 15 degrees and 22 degrees C (59 degrees and 72 degrees F])] and
flavored to enhance palatability and promote fluid replacement. Fluids
should be readily available and served in containers that allow adequate
volumes to be ingested with ease and with minimal interruption of exercise.
4. Addition of proper amounts of carbohydrates and/or electrolytes to
a fluid replacement solution is recommended for exercise events of duration
greater than 1 h since it does not significantly impair water delivery
to the body and may enhance performance. During exercise lasting less
than 1 h, there is little evidence of physiological or physical performance
differences between consuming a carbohydrate-electrolyte drink and plain
water.
5. During intense exercise lasting longer than 1 h, it is recommended
that carbohydrates be ingested at a rate of 30-60 g.h(-1) to maintain
oxidation of carbohydrates and delay fatigue. This rate of carbohydrate
intake can be achieved without compromising fluid delivery by drinking
600-1200 ml.h(-1) of solutions containing 4%-8% carbohydrates (g.100 ml(-1)).
The carbohydrates can be sugars (glucose or sucrose) or starch (e.g.,
maltodextrin).
6. Inclusion of sodium (0.5-0.7 g.1(-1) of water) in the rehydration solution
ingested during exercise lasting longer than 1 h is recommended since
it may be advantageous in enhancing palatability, promoting fluid retention,
and possibly preventing hyponatremia in certain individuals who drink
excessive quantities of fluid. There is little physiological basis for
the presence of sodium in n oral rehydration solution for enhancing intestinal
water absorption as long as sodium is sufficiently available from the
previous meal
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