Drinking Strategies: Planned Drinking Versus Drinking to Thirst
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REVIEW ARTICLE
Drinking Strategies: Planned Drinking Versus Drinking to Thirst Robert W. Kenefick1
Ó The Author(s) 2018. This article is an open access publication
Abstract In humans, thirst tends to be alleviated before complete rehydration is achieved. When sweating rates are high and ad libitum fluid consumption is not sufficient to replace sweat losses, a cumulative loss in body water results. Body mass losses of 2% or greater take time to accumulate. Dehydration of C 2% body mass is associated with impaired thermoregulatory function, elevated cardiovascular strain and, in many conditions (e.g., warmer, longer, more intense), impaired aerobic exercise performance. Circumstances where planned drinking is optimal include longer duration activities of [ 90 min, particularly in the heat; higher-intensity exercise with high sweat rates; exercise where performance is a concern; and when carbohydrate intake of 1 g/min is desired. Individuals with high sweat rates and/or those concerned with exercise performance should determine sweat rates under conditions (exercise intensity, pace) and environments similar to that anticipated when competing and tailor drinking to prevent body mass losses [ 2%. Circumstances where drinking to thirst may be sufficient include short duration exercise of \ 1 h to 90 min; exercise in cooler conditions; and lowerintensity exercise. It is recommended to never drink so much that weight is gained.
[1, 2]. These fluid consumption practices have been a topic of recent debate in the literature [3, 4]. Consensus statements and sports medicine society position stands either focus on maintaining performance and reducing cardiovascular and thermoregulatory strain, in the case of the American College of Sports Medicine guidelines [5], or preventing hyponatremia, in the case of the Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference [6]. Differences in emphasis have resulted in recommendations for fluid intake strategies that may appear to be at odds, with one position stand recommending programmed drinking [5] while a consensus statement [6] recommends an ad libitum/drink to thirst strategy. Despite apparent differences, both strategies seek to prevent over/under hydration and preserve performance. However, the success of either strategy will depend on the context of the event (duration, intensity, and environment), the characteristics of the individual (fitness, acclimatization status, etc.), and the goals of the individual exercising, training, or competing.
2 Definitions and Objectives of ‘Programmed Drinking’ and ‘Drink to Thirst’
1 Introduction The two most common schools of thought regarding the best fluid intake practices during exercise are programmed drinking versus drinking to thirst or ad libitum drinking
Defining the terminology of each fluid intake strategy is important to avoid confusion and so that specific differences between the two strategies can be fully understood. For the purposes of this review, the operational definition
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