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Fluid balance and hydration status in combat sport Olympic athletes: a systematic review with meta-analysis of controlled and uncontrolled studies

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Abstract

Purpose

Athletes in Olympic combat sports experience body water fluctuations resulting from training and intentional dehydration when making weight. Despite the popularity of urine specific gravity (USG) and urine osmolality (UOSM) measurement in characterizing fluid fluctuations, their utility remains questioned. This systematic review/meta-analysis examined the utility of urinary hydration indices in laboratory and field settings in Olympic combat sport athletes.

Methods

27 articles met the inclusion criteria for systematic review, 15 studies were included in the meta-analysis; with USG and UOSM the main outcome variables. Meta-regression analyses evaluated the interrelationship among body mass (BM), fluid intake, and urine measures.

Results

Significant USG alterations were observed following different sampling time frames: dehydration (ES 0.59; 95% CI 0.46–0.72; p = 0.001), follow-up period (ES 0.31; 95% CI 0.11–0.50; p = 0.002) and rehydration (ES − 0.34; 95% CI − 0.56 to − 0.12; p = 0.003). Direct comparison of laboratory (ES 0.20; 95% CI − 0.19 to 0.59; p = 0.324) and field (ES 0.35; 95% CI 0.14–0.56; p = 0.001) sampling showed marginally trivial and small effects. Small effects on UOSM were observed following dehydration (ES 0.31; 95% CI 0.12–0.74, p = 0.15), follow-up period (ES 0.39; 95% CI 0.08–0.70, p = 0.015) and rehydration (ES − 0.45; 95% CI − 0.60 to 0.30, p = 0.001). Meta-regression analysis suggests only fluid intake predicts USG alterations (p = 0.044) during rehydration protocols.

Conclusions

There were likely small changes in both USG and UOSM readings across all experimental conditions, with moderate-to-large heterogeneity in all studies, except for USG readings during dehydration protocols. The meta-regression failed to provide conclusive evidence concerning the interrelationship among urine measures, BM fluctuations, and fluid intake.

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This research did not receive any grant from funding agencies in the public or commercial sectors.

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Authors and Affiliations

  1. Faculty of Kinesiology, University of Split, Split, Croatia

    Damir Zubac, Igor Jelaska & Vladimir Ivancev

  2. Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia

    Damir Zubac & Armin Paravlic

  3. Gatorade Sports Science Institute, Bradenton, FL, USA

    Reid Reale

  4. Faculty of Health Sciences, University of Primorska, Polje 42, 6310, Izola, Slovenia

    Shawnda A. Morrison

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  1. Damir Zubac
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Correspondence to Damir Zubac.

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Conflict of interest

Reid Reale is an employee of the Gatorade Sports Science Institute, a division of PepsiCo, Inc.; which is a manufacturer of beverages, sports drinks and hydration products. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.

Disclosure statement

Damir Zubac, Igor Jelaska, and Vladimir Ivancev are employed by the University of Split, Faculty of Kinesiology, Split, Croatia, EU. Armin H. Paravlic and Damir Zubac are employed by the Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia, EU. Reid Reale is employed by the Gatorade Sports Science Institute, a division of PepsiCo, Inc. Shawnda Morrison is employed by the University of Primorska, Faculty of Health Sciences, Polje 42, 6310 Izola, Slovenia. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of PepsiCo, Inc.

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Zubac, D., Paravlic, A., Reale, R. et al. Fluid balance and hydration status in combat sport Olympic athletes: a systematic review with meta-analysis of controlled and uncontrolled studies. Eur J Nutr 58, 497–514 (2019). https://doi.org/10.1007/s00394-019-01937-2

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