Acknowledging that total body water (TBW) turnover is complex, and that no measurement is valid for all situations, this review evaluates 13 hydration assessment techniques. Although validated laboratory methods exist for TBW and extracellular volume, no evidence incontrovertibly demonstrates that any concentration measurement, including plasma osmolality (P(osm)), accurately represents TBW gain and loss during daily activities. Further, one blood or urine sample cannot validly represent fluctuating TBW and fluid compartments. Future research should (a) evaluate novel techniques that assess hydration in real time and are precise, accurate, reliable, non-invasive, portable, inexpensive, safe, and simple; and (b) clarify the relationship between P(osm) and TBW oscillations in various scenarios.

The present study assessed the effects of mild dehydration on cognitive performance and mood of young males. A total of twenty-six men (age 20·0 (sd0·3) years) participated in three randomised, single-blind, repeated-measures trials: exercise-induced dehydration plus a diuretic (DD; 40 mg furosemide); exercise-induced dehydration plus placebo containing no diuretic (DN); exercise while maintaining euhydration plus placebo (EU; control condition). Each trial included three 40 min treadmill walks at 5·6 km/h, 5 % grade in a 27·7°C environment. A comprehensive computerised six-task cognitive test battery, the profile of mood states questionnaire and the symptom questionnaire (headache, concentration and task difficulty) were administered during each trial. Pairedttests compared the DD and DN trials resulting in >1 % body mass loss (mean 1·59 (sd0·42) %) with the volunteer's EU trial (0·01 (sd0·03) %). Dehydration degraded specific aspects of cognitive performance: errors increased on visual vigilance (P = 0·048) and visual working memory response latency slowed (P = 0·021). Fatigue and tension/anxiety increased due to dehydration at rest (P = 0·040 and 0·029) and fatigue during exercise (P = 0·026). Plasma osmolality increased due to dehydration (P < 0·001) but resting gastrointestinal temperature was not altered (P = 0·238). In conclusion, mild dehydration without hyperthermia in men induced adverse changes in vigilance and working memory, and increased tension/anxiety and fatigue.

Recent trends in weight loss diets have led to a substantial increase in protein intake by individuals. As a result, the safety of habitually consuming dietary protein in excess of recommended intakes has been questioned. In particular, there is concern that high protein intake may promote renal damage by chronically increasing glomerular pressure and hyperfiltration. There is, however, a serious question as to whether there is significant evidence to support this relationship in healthy individuals. In fact, some studies suggest that hyperfiltration, the purported mechanism for renal damage, is a normal adaptative mechanism that occurs in response to several physiological conditions. This paper reviews the available evidence that increased dietary protein intake is a health concern in terms of the potential to initiate or promote renal disease. While protein restriction may be appropriate for treatment of existing kidney disease, we find no significant evidence for a detrimental effect of high protein intakes on kidney function in healthy persons after centuries of a high protein Western diet.

Water is essential for metabolism, substrate transport across membranes, cellular homeostasis, temperature regulation, and circulatory function. Although nutritional and physiological research teams and professional organizations have described the daily total water intakes (TWI, L/24h) and Adequate Intakes (AI) of children, women, and men, there is no widespread consensus regarding the human water requirements of different demographic groups. These requirements remain undefined because of the dynamic complexity inherent in the human water regulatory network, which involves the central nervous system and several organ systems, as well as large inter-individual differences. The present review analyzes published evidence that is relevant to these issues and presents a novel approach to assessing the daily water requirements of individuals in all sex and life-stage groups, as an alternative to AI values based on survey data. This empirical method focuses on the intensity of a specific neuroendocrine response (e.g., plasma arginine vasopressin (AVP) concentration) employed by the brain to regulate total body water volume and concentration. We consider this autonomically-controlled neuroendocrine response to be an inherent hydration biomarker and one means by which the brain maintains good health and optimal function. We also propose that this individualized method defines the elusive state of euhydration (i.e., water balance) and distinguishes it from hypohydration. Using plasma AVP concentration to analyze multiple published data sets that included both men and women, we determined that a mild neuroendocrine defense of body water commences when TWI is ˂1.8 L/24h, that 19–71% of adults in various countries consume less than this TWI each day, and consuming less than the 24-h water AI may influence the risk of dysfunctional metabolism and chronic diseases.

Context: In hot environments, the American football uniform predisposes athletes to exertional heat exhaustion or exercise-induced hyperthermia at the threshold for heat stroke (rectal temperature [T_re] > 39°C). Objective: To evaluate the differential effects of 2 American football uniform configurations on exercise, thermal, cardiovascular, hematologic, and perceptual responses in a hot, humid environment. Design: Randomized controlled trial. Setting: Human Performance Laboratory. Patients or Other Participants: Ten men with more than 3 years of competitive experience as football linemen (age = 23.8 ± 4.3 years, height = 183.9 ± 6.3 cm, mass = 117.41 ± 12.59 kg, body fat = 30.1% ± 5.5%). Intervention(s): Participants completed 3 controlled exercise protocols consisting of repetitive box lifting (lifting, carrying, and depositing a 20.4-kg box at a rate of 10 lifts per minute for 10 minutes), seated recovery (10 minutes), and up to 60 minutes of treadmill walking. They wore one of the following: a partial uniform (PART) that included the National Football League (NFL) uniform without a helmet and shoulder pads; a full uniform (FULL) that included the full NFL uniform; or control clothing (CON) that included socks, sneakers, and shorts. Exercise, meals, and hydration status were controlled. Main Outcome Measure(s): We assessed sweat rate, T_re, heart rate, blood pressure, treadmill exercise time, perceptual measurements, plasma volume, plasma lactate, plasma glucose, plasma osmolality, body mass, and fat mass. Results: During 19 of 30 experiments, participants halted exercise as a result of volitional exhaustion. Mean sweat rate, T_re, heart rate, and treadmill exercise time during the CON condition were different from those measures during the PART (P range, .04–.001; d range, 0.42–0.92) and FULL (P range, .04–.003; d range, 1.04–1.17) conditions; no differences were detected for perceptual measurements, plasma volume, plasma lactate, plasma glucose, or plasma osmolality. Exhaustion occurred during the FULL and PART conditions at the same T_re (39.2°C). Systolic and diastolic blood pressures (n = 9) indicated that hypotension developed throughout exercise (all treatments). Compared with the PART condition, the FULL condition resulted in a faster rate of T_re increase (P < .001, d = 0.79), decreased treadmill exercise time (P = .005, d = 0.48), and fewer completed exercise bouts. Interestingly, T_re increase was correlated with lean body mass during the FULL condition (R² = 0.71, P = .005), and treadmill exercise time was correlated with total fat mass during the CON (R² = 0.90, P < .001) and PART (R² = 0.69, P = .005) conditions. Conclusions: The FULL and PART conditions resulted in greater physiologic strain than the CON condition. These findings indicated that critical internal temperature and hypotension were concurrent with exhaustion during uncompensable (FULL) or nearly uncompensable (PART) heat stress and that anthropomorphic characteristics influenced heat storage and exercise time to exhaustion.