Dehydration, rehydration, and exercise in the heat: rehydration strategies for athletic competition

Exercise capacity and exercise performance are reduced when the ambient temperature is high. This has mainly been attributed to the large sweat losses which lead to hypohydration, a failure of thermoregulation, and eventually circulatory collapse. Exercising athletes rarely drink enough before or during exercise to replace the ongoing fluid losses, especially in hot conditions. In order to combat dehydration, hyperthermia, and impending circulatory collapse, athletes should drink fluids before, during, and after exercise. Preexercise strategies include attempts to maintain euhydration but also to hyperhydrate. Hyperhydration is relatively easy to achieve, but thermoregulatory benefits during prolonged exercise have not been observed in comparison to euhydration. In prolonged continuous exercise, fluid and carbohydrate (CHO) ingestion has clearly been shown to improve performance, but the evidence is not so clear for high-intensity intermittent exercise over a prolonged period. The general consensus is that fluid ingestion should match sweat losses during exercise and that the drink should contain CHO and electrolytes to assist water transport in the intestine and to improve palatability. Postexercise rehydration is essential when the strategies adopted before or during exercise have not been effective. The best postexercise rehydration strategy would be to ingest a large volume of a beverage that contains a CHO source and a high sodium content.