Efficacy of Glucose or Amino Acid–Based Commercial Beverages in Meeting Oral Rehydration Therapy Goals After Acute Hypertonic and Isotonic Dehydration

Cheuvront, Samuel N.; Kenefick, Robert W.; Charkoudian, Nisha; Mitchell, Katherine; Luippold, Adam J.; Bradbury, Karleigh E.; Vidyasagar, Sadasivan

doi:10.1002/jpen.1142

Cited by 11 publications

(14 citation statements)

References 42 publications

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“…Although subjects were in negative net fluid balance by the end of the study, indicating a greater excretion of fluid than what was consumed, there was a sustained plasma volume expansion of approximately 3-5% in the CES and MPS beverages at 240 min. The sustained mild PV expansion over at least 4 h after drinking MPS and CES likely indicates that the increased concentration of serum electrolytes helped retain some of the ingested fluid in the vascular space and possibly promoted some osmotic pull of water from the intracellular space into the vascular space [34], allowing for hemodilution, an important component of efficacious hydration [35].…”

Section: Discussionmentioning

confidence: 99%

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

et al. 2020

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Milk permeate is an electrolyte-rich, protein- and fat-free liquid with a similar carbohydrate and mineral content to that of milk. Its hydration efficacy has not been examined. The beverage hydration index (BHI) has been used to compare various beverages to water in terms of post-ingestion fluid balance and retention. Our purpose was to compare the BHI (and related physiological responses) of a novel milk permeate solution (MPS) to that of water and a traditional carbohydrate–electrolyte solution (CES). Over three visits, 12 young subjects consumed 1 L of water, CES, or MPS. Urine samples were collected immediately post-ingestion and at 60, 120, 180, and 240 min. BHI was calculated by dividing cumulative urine output after water consumption by cumulative urine output for each test beverage at each time point. The BHI for MPS was significantly higher at all time points compared to water (all p < 0.001) and CES (all p ≤ 0.01) but did not differ between CES and water at any time point. Drinking 1 L of MPS resulted in decreased cumulative urine output across the subsequent 4 h compared to water and CES, suggesting that a beverage containing milk permeate is superior to water and a traditional CES at sustaining positive fluid balance post-ingestion.

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Section: Discussionmentioning

confidence: 99%

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

et al. 2020

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“…Because the entire 1 L volume of fluid was excreted in the presence of a modest PV expansion, the hypotonic nature of the urine (Figure 4, 50-70% CH 2 O) suggests that electrolytes were retained and/or higher extracellular tonicity created a favorable osmotic pull of water from the intracellular space (35). The PV response in concert with BHI adds value, because mild expansion of the vascular space is a beneficial outcome related to fluid therapy (36).…”

Section: Discussionmentioning

confidence: 99%

A randomized trial to assess beverage hydration index in healthy older adults

Clarke

Stanhewicz

Wolf

et al. 2019

The American Journal of Clinical Nutrition

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Background: The beverage hydration index (BHI) is a composite measure of fluid balance after consuming a test beverage relative to water. BHI is a relatively new measure that has been explored in young, but not yet older, adults. Objective: The aim of this study was to investigate potential differences in BHI between euhydrated younger and older adults after drinking 4 different commercial beverages. We hypothesized that 1) older subjects would remain in positive fluid balance longer than young subjects after ingestion of each test beverage due to decreased urinary excretion rates, 2) glucose (glu)-and amino acid (AA)-based hydration beverages with sodium would have a BHI greater than water in both groups, and 3) the traditional 2-h postingestion BHI may be inappropriate for older adults. Methods: On 5 separate visits, 12 young (23 ± 3 yr, 7 M/5F) and 12 older (67 ± 6 yr, 5 M/7F) subjects consumed 1 L of distilled water, G-20 (6% CHO, 20 mmol/L Na +), G-45 (2.5% CHO, 45 mmol/L Na +), AA-30 (5 AAs, 30 mmol/L Na +), or AA-60 (8 AAs, 60 mmol/L Na +) over 30 min. Blood and urine samples were collected before ingestion and at 0, 60, 120, 180, and 240 min postingestion with additional venous blood sampling at 5, 10, 15, and 30 min postingestion. Results: In young subjects, BHI increased with increasing beverage Na + concentration, and AA-60 had the highest BHI (AA-60 = 1.24 ± 0.10 compared with water = 1.00, P = 0.01). For older subjects, BHI was highest in AA-30 (AA-30; 1.20 ± 0.13 compared with water, P < 0.01) and was still in flux beyond 2 h in AA-60 (P < 0.05). Conclusions: Beverage Na + content progressively increased BHI in young adults independent of glucose or AA content. For older adults, the AA-30 beverage had the highest BHI. A 4-h BHI may be more appropriate for older adults due to attenuated urine excretion rates. This trial was registered at clinicaltrials.gov as NCT03559101.

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“…However, the case study nature of their work did not provide an opportunity for the authors to quantify fluid losses, making conclusions regarding the athletes' actual levels of dehydration challenging. In the present study, furosemide (Lasix), a diuretic, was used to mimic dehydration caused by illness, as furosemide produces a similar profile of body water and electrolyte losses observed with secretory diarrhea 4,5,8,9 . Volunteers were dehydrated to an average 3.7% loss in body water, which caused an increase in Hb that would elicit suspicion of blood doping in the majority of subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Volunteers were dehydrated to an average 3.7% loss in body water, which caused an increase in Hb that would elicit suspicion of blood doping in the majority of subjects. This substantial impact of diuretic‐induced extracellular dehydration versus sweating may be explained by the fact that extracellular dehydration leads to twice the ratio of plasma volume loss to total body water loss, in comparison with intracellular dehydration 4,5,9 . Therefore, recent gastrointestinal illness may be a feasible explanation for elevated Hb levels during ABP testing.…”

Section: Discussionmentioning

confidence: 99%

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Potential for dehydration to impact the athlete biological passport

Coffman

Mitchell

Salgado

et al. 2020

Drug Testing and Analysis

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In order to inform the Athlete Biological Passport (ABP), this study determined whether the elevation in hemoglobin (Hb) following intracellular or extracellular dehydration would trigger an atypical passport finding (ATPF). Seven male and three female volunteers (age: 23 ± 4 y; height: 170 ± 8 cm; body mass: 78 ± 12 kg) were carefully euhydrated (EUH) to determine baseline Hb levels. Volunteers then completed both an exercise‐induced sweating dehydration (SW) protocol and a diuretic‐induced dehydration (DI) protocol. Dehydration was assessed via body mass changes and Hb was measured via a bench‐top automated hematology analyzer. Using the ABP module, the expected baseline range for each individual was determined using EUH trials, and the impact of each dehydration protocol was then assessed in comparison with these thresholds. Volunteers lost on average 3.1% and 3.7% body mass in the SW and DI trials, respectively. While only one subject exceeded the upper threshold following DI dehydration, six additional subjects demonstrated highly unusual ABP profiles; this was not the case for SW. Sweating is not a feasible explanation for elevated Hb during ABP testing; however, recent illness such as secretory diarrhea, which is mimicked by diuretic administration, may be capable of producing elevated Hb in athletes' biological passports.

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Efficacy of Glucose or Amino Acid–Based Commercial Beverages in Meeting Oral Rehydration Therapy Goals After Acute Hypertonic and Isotonic Dehydration

Abstract: The results of this study demonstrate superior rehydration when using AA compared with SP for both hypertonic and isotonic dehydration.

Cited by 11 publications

References 42 publications

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

Hydration Efficacy of a Milk Permeate-Based Oral Hydration Solution

A randomized trial to assess beverage hydration index in healthy older adults

Potential for dehydration to impact the athlete biological passport

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