Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete’s health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use.

Hydration status is not easily measured, but acute changes in hydration status are often estimated from body mass change. Changes in body mass are also often used as a proxy measure for sweat losses. There are, however, several sources of error that may give rise to misleading results, and our aim in this paper is to quantify these potential errors. Respiratory water losses can be substantial during hard work in dry environments. Mass loss also results from substrate oxidation, but this generates water of oxidation which is added to the body water pool, thus dissociating changes in body mass and hydration status: fat oxidation actually results in a net gain in body mass as the mass of carbon dioxide generated is less than the mass of oxygen consumed. Water stored with muscle glycogen is presumed to be made available as endogenous carbohydrate stores are oxidized. Fluid ingestion and sweat loss complicate the picture by altering body water distribution. Loss of hypotonic sweat results in increased osmolality of body fluids. Urine and faecal losses can be measured easily, but changes in the water content of the bladder and the gastrointestinal tract cannot. Body mass change is not always a reliable measure of changes in hydration status and substantial loss of mass may occur without an effective net negative fluid balance.

The interaction between the volume and composition of fluids ingested was investigated in terms of rehydration effectiveness. Twelve male volunteers, dehydrated by 2.06 +/- 0.02% (mean +/- SE) of body mass by intermittent cycle exercise, consumed a different drink volume on four separate weeks; six subjects received drink L (23 mmol.l-1 Na+) in each trial and six were given drink H (61 mmol.l-1 Na+). Volumes consumed were equivalent to 50%, 100%, 150%, and 200% of body mass loss (trials A, B, C, and D, respectively). Blood and urine samples were obtained before exercise and for 7.5 h after exercise. Less urine was excreted following rehydration in trial A than in all other trials. Cumulative urine output (median ml) was less in trial B (493, range 181-731) than D (1361, range 1014-1984), which was not different from trial C (867, range 263-1191) in group L. In group H, the volume excreted in trial B (260, range 137-376) was less than trials C (602, range 350-994) and D (1001, range 714-1425), and the volume in trial C was less than in trial D. These results suggest that both sodium concentration and fluid volume consumed interact to affect the rehydration process. A drink volume greater than sweat loss during exercise must be ingested to restore fluid balance, but unless the sodium content of the beverage is sufficiently high this will merely result in an increased urinary output.

Compared with a drink at 37 degrees C, the ingestion of a cold drink before and during exercise in the heat reduced physiological strain (reduced heat accumulation) during exercise, leading to an improved endurance capacity (23 +/- 6%).

Hydration status and the effects of hypohydration have been the topic of much public and scientific debate in recent years. While many physiological responses to hypohydration have been studied extensively, the subjective responses to hypohydration have largely been ignored. The present investigation was designed to investigate the physiological responses and subjective feelings resulting from 13, 24 and 37 h of fluid restriction (FR) and to compare these with a euhydration (EU) trial of the same duration in fifteen healthy volunteers. The volunteers were nine men and six women of mean age 30 (SD 12) years and body mass 71·5 (SD 13·4) kg. Urine and blood samples were collected and subjective feelings recorded on a 100 mm verbally anchored questionnaire at intervals throughout the investigation. In the EU trial the subjects maintained their normal diet. Body mass decreased by 2·7 (SD 0·6) % at 37 h in the FR trial and did not change significantly in the EU trial. Food intake in the FR trial (n 10) provided an estimated water intake of 487 (SD 335) ml and urinary losses (n 15) amounted to 1·37 (SD 0·39) litres. This is in comparison with an estimated water intake of 3168 (SD 1167) ml and a urinary loss of 2·76 (SD 1·11) litres in the EU trial. Plasma osmolality and angiotensin II concentrations increased from 0 -37 h with FR. Plasma volume decreased linearly throughout the FR trial amounting to a 6·2 (SD 5·1) % reduction by 37 h. Thirst increased from 0 -13 h of FR then did not increase further (P.0·05). The subjects reported feelings of headache during the FR trial and also that their ability to concentrate and their alertness were reduced.

Previous methods used to collect human sweat for electrolyte analysis have been criticized because they involve only regional sampling or because of methodological problems associated with whole body-washdown techniques. An improved method for collection of whole body sweat from exercising subjects is described. It involved construction of a plastic frame that supports a large plastic bag within which the subject exercises. The subject and the equipment are washed with distilled, deionized water before exercise begins. After exercise is completed, the subject and equipment are again washed with water containing a marker not present in sweat (ammonium sulfate). Total sweat loss is calculated from the change in body mass, and the volume of sweat not evaporated is calculated from dilution of the added marker. Recovery of added water was 102 +/- 2% (SD) of the added volume, and recovery of added electrolytes was 99 +/- 2% for sodium, 98 +/- 9% for potassium, and 101 +/- 4% for chloride. Repeated trials (n = 4) on five subjects to establish the reproducibility of the method gave a coefficient of variation of 17 +/- 5% for sodium, 23 +/- 6% for potassium, and 15 +/- 6% for chloride. These values include the biological variability between trials as well as the error within the method. The biological variability thus appears to be far greater than the methodological error. Normal values for the composition of sweat induced by exercise in a hot, humid environment in healthy young men and women were (in mM) 50.8 +/- 16.5 sodium, 4.8 +/- 1.6 potassium, 1.3 +/- 0.9 calcium, 0.5 +/- 0.5 magnesium, and 46.6 +/- 13.1 chloride.

The findings suggest that such an instrument could provide athletes with reliable information as to their hydration status from measurement of the first morning urine of the day and therefore provide a quick and easy method for achieving an approximation of hydration status from day-to-day.