Athlete Hydration: Beyond Performance Toward Long-Term Health

Area of Science:

• Sports Nutrition
• Exercise Physiology
• Public Health

Background:

• Acute hydration strategies dominate athlete fluid research, overshadowing potential long-term health risks of habitual low water intake (LWI).
• Emerging evidence links chronic LWI in non-athletes to renal, endocrine, and metabolic strain, including insulin resistance and inflammation.
• Up to 58% of athletes may be habitual low drinkers, despite significant fluid losses during exercise, with markers of renal stress observed.

Purpose of the Study:

• To argue that habitual LWI is an underappreciated health risk in athletic populations.
• To highlight the need for a paradigm shift in sports nutrition to consider daily water intake's impact on long-term health.
• To identify critical research gaps in longitudinal and mechanistic studies on LWI in athletes.

Main Methods:

• This communication synthesizes existing evidence on fluid balance, LWI, and associated health risks.
• It reviews data from non-athletic populations and applies it to the athletic context.
• It highlights physiological markers of sustained fluid-regulatory system activation in low-drinking athletes.

Main Results:

• Habitual LWI in athletes is a potentially modifiable health risk.
• Athletes may exhibit sustained activation of fluid-regulatory systems despite normal total body water.
• The long-term health consequences of this physiological state in athletes are currently unknown.

Conclusions:

• Habitual low water intake (LWI) represents an underappreciated health risk for athletes.
• Further longitudinal and mechanistic research is crucial to understand the long-term health implications of LWI in athletes.
• Sports nutrition guidelines should integrate total daily water intake as a key factor for both athletic performance and long-term health.