Hydration status is linked with health, wellness, and performance. We evaluated hydration status, water intake, and urine output for seven consecutive days in healthy adults. Volunteers living in Spain, Germany, or Greece (n = 573, 39 ± 12 years (51.1% males), 25.0 ± 4.6 kg/m2 BMI) participated in an eight-day study protocol. Total water intake was estimated from seven-day food and drink diaries. Hydration status was measured in urine samples collected over 24 h for seven days and in blood samples collected in fasting state on the mornings of days 1 and 8. Total daily water intake was 2.75 ± 1.01 L, water from beverages 2.10 ± 0.91 L, water from foods 0.66 ± 0.29 L. Urine parameters were: 24 h volume 1.65 ± 0.70 L, 24 h osmolality 631 ± 221 mOsmol/kg Η2Ο, 24 h specific gravity 1.017 ± 0.005, 24 h excretion of sodium 166.9 ± 54.7 mEq, 24 h excretion of potassium 72.4 ± 24.6 mEq, color chart 4.2 ± 1.4. Predictors for urine osmolality were age, country, gender, and BMI. Blood indices were: haemoglobin concentration 14.7 ± 1.7 g/dL, hematocrit 43% ± 4% and serum osmolality 294 ± 9 mOsmol/kg Η2Ο. Daily water intake was higher in summer (2.8 ± 1.02 L) than in winter (2.6 ± 0.98 L) (p = 0.019). Water intake was associated negatively with urine specific gravity, urine color, and urine sodium and potassium concentrations (p < 0.01). Applying urine osmolality cut-offs, approximately 60% of participants were euhydrated and 20% hyperhydrated or dehydrated. Most participants were euhydrated, but a substantial number of people (40%) deviated from a normal hydration level.

This study explored the effects of physical activity (PA) and ambient temperature on water turnover and hydration status. Five-hundred seventy three healthy men and women (aged 20–60 years) from Spain, Greece and Germany self-reported PA, registered all food and beverage intake, and collected 24-h urine during seven consecutive days. Fasting blood samples were collected at the onset and end of the study. Food moisture was assessed using nutritional software to account for all water intake which was subtracted from daily urine volume to allow calculation of non-renal water loss (i.e., mostly sweating). Hydration status was assessed by urine and blood osmolality. A negative association was seen between ambient temperature and PA (r = −0.277; p < 0.001). Lower PA with high temperatures did not prevent increased non-renal water losses (i.e., sweating) and elevated urine and blood osmolality (r = 0.218 to 0.163 all p < 0.001). When summer and winter data were combined PA was negatively associated with urine osmolality (r = −0.153; p = 0.001). Our data suggest that environmental heat acts to reduce voluntary PA but this is not sufficient to prevent moderate dehydration (increased osmolality). On the other hand, increased PA is associated with improved hydration status (i.e., lower urine and blood osmolality).

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