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Dehydration: Physiology, Assessment, and Performance Effects
Abstract
This article provides a comprehensive review of dehydration assessment and presents a unique evaluation of the dehydration and performance literature. The importance of osmolality and volume are emphasized when discussing the physiology, assessment, and performance effects of dehydration. The underappreciated physiologic distinction between a loss of hypo-osmotic body water (intracellular dehydration) and an iso-osmotic loss of body water (extracellular dehydration) is presented and argued as the single most essential aspect of dehydration assessment. The importance of diagnostic and biological variation analyses to dehydration assessment methods is reviewed and their use in gauging the true potential of any dehydration assessment method highlighted. The necessity for establishing proper baselines is discussed, as is the magnitude of dehydration required to elicit reliable and detectable osmotic or volume-mediated compensatory physiologic responses. The discussion of physiologic responses further helps inform and explain our analysis of the literature suggesting a ≥ 2% dehydration threshold for impaired endurance exercise performance mediated by volume loss. In contrast, no clear threshold or plausible mechanism(s) support the marginal, but potentially important, impairment in strength, and power observed with dehydration. Similarly, the potential for dehydration to impair cognition appears small and related primarily to distraction or discomfort. The impact of dehydration on any particular sport skill or task is therefore likely dependent upon the makeup of the task itself (e.g., endurance, strength, cognitive, and motor skill).
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“There are also daily fluctuations in total body water, estimated by Cheuvront et al. to have an upper-limit of ±1% of body weight (i.e., 0.6–0.9 kg in an adult of 60–90 kg) [86].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [86]
In the citing paper
“It is well established that hypohydration (>2% body mass loss; BML) can impair endurance performance, particularly in hot/humid environments [9, 12].”
From Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance (2017) · cites this paper as [12]
In the citing paper
“In general, these results are in agreement with recent reviews and meta-analyses on the effect of hypohydration on jumping ability and anaerobic power [12, 117].”
From Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance (2017) · cites this paper as [12]
In the citing paper
“Furthermore, a clear mechanism by which hyperosmolality or hypovolemia per se would impair cognition is currently lacking (for a review, see Cheuvront & Kenefick [12]).”
From Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance (2017) · cites this paper as [12]
In the citing paper
“Moreover, individual variability in cognitive resiliency (ability to overcome the stressors of hypohydration) may explain, in part, the equivocal findings in the cognition literature [12].”
From Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance (2017) · cites this paper as [12]
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Metadata
- Authors
- Cheuvront, S. N., & Kenefick, R. W.
- Affiliations
- U.S. Army Research Institute of Environmental Medicine (US)
- ORCID
- Cheuvront, Samuel N.
- Venue
- Comprehensive Physiology
- Publisher
- Wiley
- Published
- 2014-01-10
- Volume
- 4
- Issue
- 1
- Pages
- 257-285
- ISSN
- 2040-4603 (ISSN-L)
- OpenAlex
- W1665634335
- Cited by
- 461
- References
- 385
- Citations by year
- 2026: 17 · 2025: 26 · 2024: 49 · 2023: 50 · 2022: 37 · 2021: 52 · 2020: 48 · 2019: 57 · 2018: 37 · 2017: 24 · 2016: 30 · 2015: 27 · 2014: 7
- Type
- other
- Language
- en
- Open access
- closed
- Locations
- Comprehensive physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- dehydration, dehydration assessment, osmolality, intracellular dehydration, extracellular dehydration, body water loss, endurance exercise performance, strength and power, cognitive performance, diagnostic variation, baseline establishment
- MeSH terms
- Body Water, Dehydration, Humans, Osmolar Concentration, Physical Endurance, Water-Electrolyte Balance, Body Mass Index, Extracellular Fluid
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