Sports Medicine ( IF 9.3 ) Pub Date : 2023-07-25 , DOI: 10.1007/s40279-023-01885-2 William T Jardine 1 , Brad Aisbett 1 , Monica K Kelly 1 , Louise M Burke 2 , Megan L Ross 2 , Dominique Condo 1 , Julien D Périard 3 , Amelia J Carr 1
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Background
Fluid loss during prolonged exercise in hot conditions poses thermoregulatory and cardiovascular challenges for athletes that can lead to impaired performance. Pre-exercise hyperhydration using nutritional aids is a strategy that may prevent or delay the adverse effects of dehydration and attenuate the impact of heat stress on exercise performance.
Objectives
The aim of this systematic review was to examine the current literature to determine the effect of pre-exercise hyperhydration on performance, key physiological responses and gastrointestinal symptoms.
Methods
English language, full-text articles that compared the intervention with a baseline or placebo condition were included. An electronic search of Medline Complete, SPORTDiscus and Embase were used to identify articles with the final search conducted on 11 October 2022. Studies were assessed using the American Dietetic Association Quality Criteria Checklist.
Results
Thirty-eight studies involving 403 participants (n = 361 males) were included in this review (n = 22 assessed exercise performance or capacity). Two studies reported an improvement in time-trial performance (range 5.7–11.4%), three studies reported an improvement in total work completed (kJ) (range 4–5%) and five studies reported an increase in exercise capacity (range 14.3–26.2%). During constant work rate exercise, nine studies observed a reduced mean heart rate (range 3–11 beats min−1), and eight studies reported a reduced mean core temperature (range 0.1–0.8 °C). Ten studies reported an increase in plasma volume (range 3.5–12.6%) compared with a control. Gastrointestinal symptoms were reported in 26 studies, with differences in severity potentially associated with factors within the ingestion protocol of each study (e.g. treatment, dose, ingestion rate).
Conclusions
Pre-exercise hyperhydration may improve exercise capacity during constant work rate exercise due to a reduced heart rate and core temperature, stemming from an acute increase in plasma volume. The combination of different osmotic aids (e.g. glycerol and sodium) may enhance fluid retention and this area should continue to be explored. Future research should utilise valid and reliable methods of assessing gastrointestinal symptoms. Furthermore, studies should investigate the effect of hyperhydration on different exercise modalities whilst implementing a strong level of blinding. Finally, females are vastly underrepresented, and this remains a key area of interest in this area.
中文翻译：
运动前水分过多对运动表现、生理结果和胃肠道症状的影响：系统评价
背景
在炎热条件下长时间运动时的液体流失会给运动员的体温调节和心血管带来挑战，从而导致运动表现受损。运动前使用营养辅助剂进行过度水合是一种可以预防或延迟脱水的不利影响并减轻热应激对运动表现的影响的策略。
目标
本系统综述的目的是检查现有文献，以确定运动前过度水合对运动表现、关键生理反应和胃肠道症状的影响。
方法
其中包括将干预措施与基线或安慰剂条件进行比较的英文全文文章。使用 Medline Complete、SPORTDiscus 和 Embase 的电子检索来识别文章，最终检索于 2022 年 10 月 11 日进行。研究使用美国饮食协会质量标准清单进行评估。
结果
本次综述纳入了38 项研究，涉及 403 名参与者（n = 361 名男性）（ n = 22 名评估的运动表现或能力）。两项研究报告计时赛表现有所改善（范围 5.7-11.4%），三项研究报告完成总做功（kJ）有所改善（范围 4-5%），五项研究报告运动能力有所提高（范围 14.3- 26.2%）。在恒定工作率运动期间，九项研究观察到平均心率降低（范围 3-11 次/分钟-1），八项研究报告平均核心温度降低（范围 0.1-0.8 °C）。十项研究报告称，与对照组相比，血浆容量有所增加（范围 3.5-12.6%）。26 项研究报告了胃肠道症状，其严重程度的差异可能与每项研究的摄入方案中的因素（例如治疗、剂量、摄入率）有关。
结论
由于血浆容量急剧增加而导致心率和核心温度降低，运动前的过度水合可以提高恒定工作率运动期间的运动能力。不同渗透助剂（例如甘油和钠）的组合可能会增强液体潴留，这一领域应继续探索。未来的研究应该利用有效且可靠的方法来评估胃肠道症状。此外，研究应该调查过度水合对不同运动方式的影响，同时实施高水平的盲法。最后，女性的代表性严重不足，这仍然是该领域关注的一个关键领域。
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