Reviewing the current methods of assessing hydration in athletes

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(2020) 17:52

REVIEW

Open Access

Reviewing the current methods of assessing hydration in athletes Oliver R. Barley1* , Dale W. Chapman1,2 and Chris R. Abbiss1

Abstract Background: Despite a substantial body of research, no clear best practice guidelines exist for the assessment of hydration in athletes. Body water is stored in and shifted between different sites throughout the body complicating hydration assessment. This review seeks to highlight the unique strengths and limitations of various hydration assessment methods described in the literature as well as providing best practice guidelines. Main body: There is a plethora of methods that range in validity and reliability, including complicated and invasive methods (i.e. neutron activation analysis and stable isotope dilution), to moderately invasive blood, urine and salivary variables, progressing to non-invasive metrics such as tear osmolality, body mass, bioimpedance analysis, and sensation of thirst. Any single assessment of hydration status is problematic. Instead, the recommended approach is to use a combination, which have complementary strengths, which increase accuracy and validity. If methods such as salivary variables, urine colour, vital signs and sensation of thirst are utilised in isolation, great care must be taken due to their lack of sensitivity, reliability and/or accuracy. Detailed assessments such as neutron activation and stable isotope dilution analysis are highly accurate but expensive, with significant time delays due to data analysis providing little potential for immediate action. While alternative variables such as hormonal and electrolyte concentration, bioimpedance and tear osmolality require further research to determine their validity and reliability before inclusion into any test battery. Conclusion: To improve best practice additional comprehensive research is required to further the scientific understanding of evaluating hydration status. Keywords: Hydration, Water balance, Fluid, Dehydration, Hypohydration

Background Homeostatic water balance is essential to life given the role it plays in metabolism, transportation, circulation and temperature regulation [1]. When an individual has a normal body water content they are euhydrated, whereas if they have lower than normal content, they are hypohydrated. The term “dehydration” refers to the process of losing body water but is often used incorrectly to describe hypohydration [2]. Body water is lost * Correspondence: [email protected] 1 Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia Full list of author information is available at the end of the article

through the kidneys, skin (i.e. sweating), respiratory system and gastrointestinal system [3, 4]. Severe hypohydration resulting from excessive sweating during exercise or diarrhoea can have life threatening consequences [1]. Additionally, excessive fluid consumption can pose a risk to health [1]. Hydration status