Dehydration of young athletes: diagnostic methods, correction of blood rheology, water-electrolyte and acid-base balance using an isotonic specialized drink based on apian and herbal components

Objective. To evaluate the hydration in young athletes after a 1-month intake of a specialized isotonic drink for children based on apian and herbal components F25 IsoDrink Light (IsoDrink-L).

Materials and methods. From 76 young athletes under 18 years old, of which 70 from the Ugra boarding school of the Olympic reserve of Khanty-Mansiysk (ice hockey, swimming, skiing, biathlon) and 6 highly qualified swimmers from the St. Petersburg Swimming Center Petersburg, the main group included 42 athletes with a monthly course of IsoDrink-L. The control group included 34 people who used college rehydration methods (water and regularly purchased isotonic “X”). Hydration was studied using an impedance assessment of body composition, including the calculation of the total amount of fluid (TAF), as well as intracellular and extracellular fluid (Intracell. fluid and Extracell. fluid), the Extracell. fluid/TAF ratio and a survey of participants about the method of rehydration (water or isotonic). The biochemical composition of blood, specific gravity and color of morning urine before and after a monthly course of isotonics were also evaluated.

Results. Bioimpedance measurement of the amount and ratio of body water in combination with an assessment of hematocrit, sodium, potassium, urea and lactate in the blood, as well as the specific gravity and color of morning urine made it possible to detect dehydration in all athletes before taking isotonic. The picture of dehydration in the form of cellular hyperhydration, extracellular hypohydration, hyponatremia, hypovolemia, blood “thickening and acidification” was detailed. A monthly course of isotonic demonstrated its efficiency, dehydration in athletes was eliminated. In the control group, no positive dynamics were noted, which raised the question of the inefficiency of the isotonic “X” and the harmfulness of water, which in 95 % of cases was used as a means of rehydration. The high efficiency of IsoDrink-L and the bioimpedance method was confirmed by the inverse correlation of Extracell. fluid/TAF with the level of hematocrit (r = –0.71; p < 0.0001) and lactate (r = –0.56; p < 0.0001), Extracell. fluid with the level of hematocrit (r = –0.65; p < 0.0001) and lactate (r = –0.56; p < 0.0001). The ratios of Extracell. fluid/TAF with the specific gravity of urine (r = –0.74; p < 0.0001) and its color (r = –0.65; p < 0.0001), as well as direct correlations of the Intracellular fluid with the specific gravity of urine (r = 0.79; p < 0.0001) and its color (r = 0.87; p < 0.0001).

Conclusion. Uncontrolled hydration, especially with water, does not allow maintaining a balance of sodium and fluid in young athletes, as a result of which there is intracellular hyperhydration, extracellular hypohydration, hyponatremia, polycythemic hypovolemia, worsening of blood rheology, its thickening and acidification. Up to 95 % of young athletes perform rehydration with water, not suspecting that this only enhances dehydration. Up to 5 % of highly qualified young athletes use isotonics, not knowing if they are effective. Isotonic F25 IsoDrink Light entered the FMBA Formula as a specialized isotonic drink for young athletes of the Russian national teams.

1. James L.J., Moss J., Henry J., Papandopoulou C., Mears S.A. Hypohydration Impairs Endurance Performance: A Blinded Study. Physiol Rep. 2017;5(12):13315. https://doi.org/10.14814/phy2.13315

2. Watso J.C., Farquhar W.B. Hydration Status and Cardiovascular Function. Nutrients. 2019;11(8):1866. https://doi.org/10.3390/nu11081866

3. Cohen D. The truth about sports drinks. BMJ. 2012;345:4737. https://doi.org/10.1136/bmj.e4737

4. Goulet E.D., Dion T., Savoie F.A. Does mild hypohydration really reduce cycling endurance performance in the heat? Med Sci Sports Exerc. 2014;46(1):207. https://doi.org/10.1249/mss.0b013e3182a17c0e

5. Nikityuk D.B., Miroshnikova Yu.V., Burlyaeva E.A., Vybornov V.D., Balandin M.Yu., Timoshenko K.T. Methodical recommendations for nutrition of young athletes. Moscow; 2017:134. (In Russ.).

6. Campbell B., Wilborn C., La Bounty P., Taylor L., Nelson M.T., Greenwood M., et al. International Society of Sports Nutrition position stand: energy drinks. J Int Soc Sports Nutr. 2013;10(1):1. https://doi.org/10.1186/1550-2783-10-1

7. Report of Science Committee on Food on composition and specification of food intended to meet the expenditure of intense muscular effort, especially for sportsmen (Adopted by the SCF on 22/6/2000, corrected by the SCF on 28/2/2001) [Internet]. Available at: https://ec.europa.eu/food/sites/food/files/safety/docs/sci-com_scf_out64_en.pdf

8. Arnaoutis G., Kavouras S.A., Kotsis Y.P., Tsekouras Y.E., Makrillos M., et al. Ad Libitum Fluid Intake Does Not Prevent Dehydration in Suboptimally hydrated young soccer players during a training session of a summer camp. International Journal of Sport Nutrition and Exercise Metabolism. 2013;23(3):245–251. https://doi.org/10.1123/ijsnem.23.3.245

9. Parastaev S.A., Miroshnikova Yu.V., Pushkina T.A., Kurashvili V.A., Yashin T.A., Vykhodets I.T., et al. An update on dehydration in athletes. Vestnik RGMU = Bulletin of Russian State Medical University. 2017;(6):13–18. (In Russ.). https://doi.org/10.24075/brsmu.2017-06-02

10. Martinchik A.N., Baeva V.S., Peskova E.V., Kudryavtseva K.V., Denisova N.N., Lavrinenko S.V., et al. Actual liquid consumption by highly qualified athletes in the mode of the training process. Voprosy pitaniya = Problems of nutrition 2018; (3):36–44. (In Russ.). https://doi.org/10.24411/0042-8833-2018-10029

11. Vykhodets I.T., Kurashvili V.A., Miroshnikova Yu.V., Nistratov S.L., Parastaev S.A., Polyaev B.A., et al. Clinical guidelines for the methods of rehydration of the athlete’s body in various Olympic sports during training events and sports competitions. Moscow: FMBA Rossii; 2018:54. (In Russ.).

12. National standard of the Russian Federation GOST R 56034-2014: Clinical guidelines (treatment protocols). General Provisions. Moscow: Standartinform; 2015:20. (In Russ.).

13. Gavrilova N.B., Shchetinin M.P., Moliboga E.A. Modern state and prospects of the development of production of specialized foodstuffs for athletes. Voprosy pitaniya = Problems of nutrition. 2017;(2):100–106. (In Russ.). https://doi.org/10.24411/0042-8833-2017-00039

14. Morgan-junior E., Megid S.M. Clinical Anesthesiology. Book 2. Moscow, SPb.: Publishing house BRSHOM-Nevsky Dialect; 2000. 366 p.

15. McDermott B.P., Anderson S.A., Armstrong L.E., Casa D.J., Cheuvront S.N., Cooper L., et al. National Athletic Trainers’ Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train. 2017;52(9):877–895. https://doi.org/10.4085/1062-6050-52.9.02

16. Knechtle B., Chlibkova D., Nikolaidis P.T. Exercise-Asso­ciated Hyponatremia in Endurance Performance. Praxis. 2019;108(9):615–632. https://doi.org/10.1024/1661-8157/a003261

17. Hew-Butler T. Exercise-Associated Hyponatremia. Front Horm Res. 2019;52:178–189. https://doi.org/10.1159/000493247

18. Sommerfield L.M., McAnulty S.R., McBride J.M., Zwetsloot J.J., Austin M.D., Mehlhorn J.D., et al. Validity of urine specific gravity when compared with plasma osmolality as a measure of hydration status in male and female NCAA collegiate athletes. J Strength Cond Res. 2016;30(8):2219–2225. https://doi.org/10.1519/jsc.0000000000001313

19. Zubac D., Cular D., Marusic U. Reliability of Urinary Dehydration Markers in Elite Youth Boxers. Int J Sports Physiol Perform. 2018;13(3):374–381. https://doi.org/10.1123/ijspp.2016-0621

20. Barnes K.A., Anderson M.L., Stofan J.R., Dalrymple K.J., Reimel A.J., Roberts T.J., et al. Normative Data for Sweating Rate, Sweat Sodium Concentration, and Sweat Sodium Loss in Athletes: An Update and Analysis by Sport. J Sports Sci. 2019;37(20):2356–2366. https://doi.org/10.1080/02640414.2019.1633159

21. Baker L.B., Wolfe A.S. Physiological mechanisms determining eccrine sweat composition. Eur J Appl Physiol. 2020;120(4):719–752. https://doi.org/10.1007/s00421-020-04323-7

22. Castizo-Olier J., Carrasco-Marginet M., Roy A., Chaverri D., Iglesias X., Perez-Chirinos C., et al. Bioelectrical Impedance Vector Analysis (BIVA) and Body Mass Changes in an Ultra-Endurance Triathlon Event. J Sports Sci Med. 2018;17(4):571–579.

23. Solov’ev V.B., Volodin R.N. Izuchenie roli suktsinatdegidrogenazy v mekhanizmakh povysheniya kontsentratsii molochnoy kisloty pri poroge anaerobnoy nagruzki. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Estestvennye nauki = University proceedings. Volga region. Natural sciences. 2016;16(4):38–43. (In Russ.). https://doi.org/10.21685/2307-9150-2016-4-4

24. Arnold A.R., Chassaing B. Maltodextrin, Modern Stressor of the Intestinal Environment. Cell Mol Gastroenterol Hepatol. 2019;7(2):475–476. https://doi.org/10.1016/j.jcmgh.2018.09.014

25. Laudisi F., Srolfi C. Impact of Food Additives on Gut Homeostasis. Nutrients. 2019;11(10):2334. https://doi.org/10.3390/nu11102334