Sports Medicine

, Volume 49, Issue 2, pp 221–232 | Cite as

Impact of Ad Libitum Versus Programmed Drinking on Endurance Performance: A Systematic Review with Meta-Analysis

  • Eric D. B. GouletEmail author
  • Martin D. Hoffman
Systematic Review



Debate continues on how athletes should hydrate during exercise. Several studies have recently been published comparing the effect of ad libitum (ALD) and programmed drinking (PD) on endurance performance (EP).


This work examined whether one drinking strategy offers an EP advantage over the other.


Systematic review and meta-analysis of crossover controlled trials.

Data Sources

PubMed and SPORTDiscus database searches.

Eligibility Criteria for Selecting Studies

Key criteria were (1) experiments performed under controlled settings; (2) exercise lasting ≥ 1 h; (3) exercise initiated in an euhydrated state; (4) fluid intake during PD > ALD; (5) fluid composition matched for electrolytes; and (6) carbohydrate intake varied by > 25% between conditions when the exercise was 1 h and matched for exercise > 1 h.


Seven publications, producing eight effect estimates, including cycling and running exercises and representing 82 subjects, were included. Mean (± standard deviation) ambient temperature, exercise intensity and duration of the experiments were 28 ± 6 °C, 81 ± 12% of maximal heart rate and 96 ± 25 min, respectively. Mean rate of fluid consumption for the PD and ALD conditions was 1073 ± 247 mL/h and 505 ± 156 mL/h, respectively. Mean change in body mass for the PD and ALD conditions was − 1.0 ± 0.5% and − 2.1 ± 0.7%, respectively. Compared with PD, ALD improved EP by 0.98 ± 0.44% (95% confidence interval 0.11–1.84%). The greater EP conferred by ALD is likely trivial.


Despite ALD being associated with an hourly rate of fluid consumption half as much as PD, and resulting in a dehydration level considered sufficient to impair EP, both strategies were found to similarly impact 1–2 h cycling or running performances conducted at moderate to high intensity and under temperate to warm ambient conditions.


Compliance with Ethical Standards


No funding was received for the conduct of this work or the preparation of this article.

Conflict of Interest

Eric D. B. Goulet and Martin D. Hoffman declare they have no potential conflicts of interest that are directly relevant to the content of this article.


  1. 1.
    Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. American College of Sports Medicine position stand. Exertional heat illness during training and competition. Med Sci Sports Exerc. 2007;39(3):556–72.CrossRefGoogle Scholar
  2. 2.
    Casa DJ, Clarkson PM, Roberts WO. American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Curr Sports Med Rep. 2005;4(3):115–27.CrossRefGoogle Scholar
  3. 3.
    Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39(2):377–90.CrossRefGoogle Scholar
  4. 4.
    McDermott BP, Anderson SA, Armstrong LE, Casa DJ, Cheuvront SN, Cooper L, et al. National athletic trainers’ association position statement: fluid replacement for the physically active. J Athl Train. 2017;52(9):877–95.CrossRefGoogle Scholar
  5. 5.
    Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Reiff RV, Rich BS, et al. National athletic trainers’ association position statement: fluid replacement for athletes. J Athl Train. 2000;35(2):212–24.Google Scholar
  6. 6.
    Kreider RB, Wilborn CD, Taylor L, Campbell B, Almada AL, Collins R, et al. ISSN exercise and sport nutrition review: research and recommendations. J Int Soc Sports Nutr. 2010;7:7.CrossRefGoogle Scholar
  7. 7.
    Thomas DT, Erdman KA, Burke LM. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. J Acad Nutr Diet. 2016;116(3):501–28.CrossRefGoogle Scholar
  8. 8.
    Hew-Butler T, Verbalis JG, Noakes TD. Updated fluid recommendation: position statement from the International Marathon Medical Directors Association (IMMDA). Clin J Sport Med. 2006;16(4):283–92.CrossRefGoogle Scholar
  9. 9.
    Hew-Butler T, Rosner MH, Fowkes-Godek S, Dugas JP, Hoffman MD, Lewis DP, et al. Statement of the 3rd International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Br J Sports Med. 2015;49(22):1432–46.CrossRefGoogle Scholar
  10. 10.
    Sawka MN, Noakes TD. Does dehydration impair exercise performance? Med Sci Sports Exerc. 2007;39(8):1209–17.CrossRefGoogle Scholar
  11. 11.
    Holland JJ, Skinner TL, Irwin CG, Leveritt MD, Goulet EDB. The influence of drinking fluid on endurance cycling performance: a meta-analysis. Sports Med. 2017;47(11):2269–84.CrossRefGoogle Scholar
  12. 12.
    Goulet ED. Effect of exercise-induced dehydration on time-trial exercise performance: a meta-analysis. Br J Sports Med. 2011;45(14):1149–56.CrossRefGoogle Scholar
  13. 13.
    Backx K, van Someren KA, Palmer GS. One hour cycling performance is not affected by ingested fluid volume. Int J Sport Nutr Exerc Metab. 2003;13(3):333–42.CrossRefGoogle Scholar
  14. 14.
    Dugas JP, Oosthuizen U, Tucker R, Noakes TD. Rates of fluid ingestion alter pacing but not thermoregulatory responses during prolonged exercise in hot and humid conditions with appropriate convective cooling. Eur J Appl Physiol. 2009;105(1):69–80.CrossRefGoogle Scholar
  15. 15.
    Backes TP, Fitzgerald K. Fluid consumption, exercise, and cognitive performance. Biol Sport. 2016;33(3):291–6.CrossRefGoogle Scholar
  16. 16.
    Bardis CN, Kavouras SA, Adams JD, Geladas ND, Panagiotakos DB, Sidossis LS. Prescribed drinking leads to better cycling performance than ad libitum drinking. Med Sci Sports Exerc. 2017;49(6):1244–51.CrossRefGoogle Scholar
  17. 17.
    Dion T, Savoie FA, Asselin A, Gariepy C, Goulet ED. Half-marathon running performance is not improved by a rate of fluid intake above that dictated by thirst sensation in trained distance runners. Eur J Appl Physiol. 2013;113(12):3011–20.CrossRefGoogle Scholar
  18. 18.
    Lee MJ, Hammond KM, Vasdev A, Poole KL, Impey SG, Close GL, et al. Self-selecting fluid intake while maintaining high carbohydrate availability does not impair half-marathon performance. Int J Sports Med. 2014;35(14):1216–22.CrossRefGoogle Scholar
  19. 19.
    Lopez RM, Casa DJ, Jensen KA, Stearns RL, DeMartini JK, Pagnotta KD, et al. Comparison of two fluid replacement protocols during a 20-km trail running race in the heat. J Strength Cond Res. 2016;30(9):2609–16.CrossRefGoogle Scholar
  20. 20.
    Sawka MN, Cheuvront SN, Kenefick RW. Hypohydration and human performance: impact of environment and physiological mechanisms. Sports Med. 2015;45(Suppl 1):S51–60.CrossRefGoogle Scholar
  21. 21.
    Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol. 2014;4(1):257–85.CrossRefGoogle Scholar
  22. 22.
    Goulet ED. Effect of exercise-induced dehydration on endurance performance: evaluating the impact of exercise protocols on outcomes using a meta-analytic procedure. Br J Sports Med. 2013;47(11):679–86.CrossRefGoogle Scholar
  23. 23.
    Jeukendrup AE. Nutrition for endurance sports: marathon, triathlon, and road cycling. J Sports Sci. 2011;29(Suppl 1):S91–9.CrossRefGoogle Scholar
  24. 24.
    Daries HN, Noakes TD, Dennis SC. Effect of fluid intake volume on 2-h running performances in a 25 degrees C environment. Med Sci Sports Exerc. 2000;32(10):1783–9.CrossRefGoogle Scholar
  25. 25.
    Passe D, Horn M, Stofan J, Horswill C, Murray R. Voluntary dehydration in runners despite favorable conditions for fluid intake. Int J Sport Nutr Exerc Metab. 2007;17(3):284–95.CrossRefGoogle Scholar
  26. 26.
    Rollo I, Williams C, Croft L, James L. The effect of carbohydrate-electrolyte beverage drinking strategy on 10 mile running performance. Int J Sport Nutr Exerc Metab. 2012;22(5):1–27.CrossRefGoogle Scholar
  27. 27.
    Suzuki K, Hashimoto H, Oh T, Ishijima T, Mitsuda H, Peake JM, et al. The effects of sports drink osmolality on fluid intake and immunoendocrine responses to cycling in hot conditions. J Nutr Sci Vitaminol (Tokyo). 2013;59(3):206–12.CrossRefGoogle Scholar
  28. 28.
    Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37(1):153–6.CrossRefGoogle Scholar
  29. 29.
    Hawley JA, Noakes TD. Peak power output predicts maximal oxygen uptake and performance time in trained cyclists. Eur J Appl Physiol Occup Physiol. 1992;65(1):79–83.CrossRefGoogle Scholar
  30. 30.
    Zoladz JA, Szkutnik Z, Majerczak J, Duda K. Non-linear relationship between oxygen uptake and power output in the Astrand nomogram: old data revisited. J Physiol Pharmacol. 2007;58(2):265–73.Google Scholar
  31. 31.
    Londeree BR, Thomas TR, Ziogas G. %VO2max versus %HRmax regressions for six modes of exercise. Med Sci Sports Exerc. 1995;27:458.CrossRefGoogle Scholar
  32. 32.
    Hoffman MD, Goulet EDB, Maughan RJ. Considerations in the use of body mass change to estimate change in hydration status during a 161-kilometer ultramarathon running competition. Sports Med. 2018;48(2):243–50.CrossRefGoogle Scholar
  33. 33.
    Maughan RJ, Shirreffs SM, Leiper JB. Errors in the estimation of hydration status from changes in body mass. J Sports Sci. 2007;25(7):797–804.CrossRefGoogle Scholar
  34. 34.
    Hopkins WG. How to interpret changes in an athletic performance test. Sportscience. 2004;8:1–7.Google Scholar
  35. 35.
    Hopkins WG, Schabort EJ, Hawley JA. Reliability of power in physical performance tests. Sports Med. 2001;31(3):211–34.CrossRefGoogle Scholar
  36. 36.
    Lipsey M, Wilson D. Practical meta-analysis. Thousand Oaks: Sage Publications; 2000.Google Scholar
  37. 37.
    Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992;45(7):769–73.CrossRefGoogle Scholar
  38. 38.
    Hopkins WG. A spreadsheet for deriving a confidence interval, mechanistic inference and clinical inference from a p value. Sportscience. 2007;11:16–20.Google Scholar
  39. 39.
    Pelletier DM, Lacerte G, Goulet ED. Effects of quercetin supplementation on endurance performance and maximal oxygen consumption: a meta-analysis. Int J Sport Nutr Exerc Metab. 2013;23(1):73–82.CrossRefGoogle Scholar
  40. 40.
    Borenstein M, Hedges LV, Higgins JPT, Rothstein H. Introduction to meta-analysis. New York: Wiley; 2009.CrossRefGoogle Scholar
  41. 41.
    Higgins JP, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc. 2009;172(1):137–59.CrossRefGoogle Scholar
  42. 42.
    Juni P, Witschi A, Bloch R, Egger M. The hazards of scoring the quality of clinical trials for meta-analysis. JAMA. 1999;282(11):1054–60.CrossRefGoogle Scholar
  43. 43.
    Baker LB. Sweating rate and sweat sodium concentration in athletes: a review of methodology and intra/interindividual variability. Sports Med. 2017;47(Suppl 1):111–28.CrossRefGoogle Scholar
  44. 44.
    Kenney WL, Chiu P. Influence of age on thirst and fluid intake. Med Sci Sports Exerc. 2001;33(9):1524–32.CrossRefGoogle Scholar
  45. 45.
    Kenefick RW, Hazzard MP, Mahood NV, Castellani JW. Thirst sensations and AVP responses at rest and during exercise-cold exposure. Med Sci Sports Exerc. 2004;36(9):1528–34.CrossRefGoogle Scholar
  46. 46.
    Armstrong LE, Maresh CM. The induction and decay of heat acclimatisation in trained athletes. Sports Med. 1991;12(5):302–12.CrossRefGoogle Scholar
  47. 47.
    Goulet ED. Dehydration and endurance performance in competitive athletes. Nutr Rev. 2012;70(Suppl 2):S132–6.CrossRefGoogle Scholar
  48. 48.
    Cheuvront SN, Montain SJ. Myths and methodologies: making sense of exercise mass and water balance. Exp Physiol. 2017;102(9):1047–53.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Performance, Hydration and Thermoregulation Laboratory, Faculty of Physical Activity SciencesUniversity of SherbrookeSherbrookeCanada
  2. 2.Research Centre on AgingUniversity of SherbrookeSherbrookeCanada
  3. 3.Physical Medicine and Rehabilitation Service, Department of Veterans AffairsNorthern California Health Care SystemSacramentoUSA
  4. 4.Department of Physical Medicine and RehabilitationUniversity of California Davis Medical CenterSacramentoUSA
  5. 5.Ultra Sports Science FoundationEl Dorado HillsUSA

Personalised recommendations