Oral Rehydration Beverages for Treating Exercise-Associated Dehydration: A Systematic Review, Part I....

Exercise-associated dehydration is a common problem, especially at sporting events. Although recommendations have been made to drink a certain volume per kilogram body mass lost after exercise, no clear guidance about the type of rehydration beverage is available. We conducted a systematic review to assess the effectiveness of carbohydrate-electrolyte (CE) solutions as a rehydration solution for exercise-associated dehydration.

MEDLINE (via the PubMed interface), Embase, and the Cochrane Library databases were searched up until June 1, 2022.

Controlled trials involving adults and children were included when dehydration was the result of physical exercise and when drinking carbohydrate-electrolyte solutions, of any percentage carbohydrate, was compared with drinking water. All languages were included if an English abstract was available.

Data on study design, study population, interventions, outcome measures, and study limitations were extracted from each included article. Certainty was assessed using Grading of Recommendations Assessment, Development and Evaluation.

Of 3485 articles screened, 19 articles in which authors assessed CE solutions (0%-9% carbohydrate) compared with water were included. Although variability was present among the identified studies, drinking 0% to 3.9% and especially 4% to 9% CE solution may be effective for rehydration.

A potential beneficial effect of drinking CE drinks compared with water was observed for many of the reviewed outcomes. Commercial CE drinks (ideally 4%-9% CE drinks or alternatively 0%-3.9% CE drinks) could be suggested for rehydration in individuals with exercise-associated dehydration when whole foods are not available.