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Cited by 252Thermoregulation and physiological responsesSports Performance and TrainingSports injuries and prevention

The DOI matches its Crossref record; 182 of the 183 references it cites were found in a registry or an index; none of the 251 sources its claims cite is checked for support yet.

Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance

Open access
Nuccio, Ryan P., Barnes, Kelly A., Carter, James M., Baker, Lindsay B.·2017·Sports Medicine
DOI 10.1007/s40279-017-0738-7PMC PMC5603646
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Abstract

Sweat losses in team sports can be significant due to repeated bursts of high-intensity activity, as well as the large body size of athletes, equipment and uniform requirements, and environmental heat stress often present during training and competition. In this paper we aimed to: (1) describe sweat losses and fluid balance changes reported in team sport athletes, (2) review the literature assessing the impact of hypohydration on cognitive, technical, and physical performance in sports-specific studies, (3) briefly review the potential mechanisms by which hypohydration may impact team sport performance, and (4) discuss considerations for future directions. Significant hypohydration (mean body mass loss (BML) >2%) has been reported most consistently in soccer. Although American Football, rugby, basketball, tennis, and ice hockey have reported high sweating rates, fluid balance disturbances have generally been mild (mean BML <2%), suggesting that drinking opportunities were sufficient for most athletes to offset significant fluid losses. The effect of hydration status on team sport performance has been studied mostly in soccer, basketball, cricket, and baseball, with mixed results. Hypohydration typically impaired performance at higher levels of BML (3-4%) and when the method of dehydration involved heat stress. Increased subjective ratings of fatigue and perceived exertion consistently accompanied hypohydration and could explain, in part, the performance impairments reported in some studies. More research is needed to develop valid, reliable, and sensitive sport-specific protocols and should be used in future studies to determine the effects of hypohydration and modifying factors (e.g., age, sex, athlete caliber) on team sport performance.

Overview

CoChat Summary

TL;DR

This review compiles fluid balance and hypohydration performance effects in team sport athletes. Significant hypohydration (>2% body mass loss) is reported most consistently in soccer, while performance impairments are mixed but more likely at 3–4% body mass loss and when dehydration involves heat stress.

Key findings

  • In soccer, mean sweating rate ranged from 0.3–2.5 L/h and mean fluid balance from +0.4% to −3.5% body mass; significant hypohydration (>2% BML) was reported most consistently in soccer. American Football, rugby, basketball, tennis, and ice hockey showed high sweating rates, but fluid balance disturbances were generally mild (mean BML <2%).
  • Across 20 original performance studies, hypohydration typically impaired performance at higher BML (3–4% difference between trials) and when dehydration involved heat stress. For example, in basketball, total sprint time was longer by ~7%, ~8%, and ~16% at 2%, 3%, and 4% BML, and total shots made decreased by 7–12% at 2–4% BML; in cricket, fluid restriction to 3.7% BML reduced bowling accuracy by 19.8% and throwing accuracy by 22.3% (sidearm) and 14.2% (overarm).
  • Increased subjective ratings of fatigue and perceived exertion consistently accompanied hypohydration; 10 of 11 team sport studies measuring perceived exertion or fatigue found significantly elevated ratings with fluid restriction versus fluid intake.
  • Cognitive and skill effects were equivocal: cognition was impaired in some studies (e.g., vigilance, decision-making time, working-memory reaction time, reactive agility) but not others; skill was impaired in basketball and cricket at ~2–4% BML, with minimal impact in soccer, field hockey, and tennis.

Methods

  • Narrative review using PubMed and EBSCO searches through September 2016, including English-language full-length peer-reviewed articles; abstracts and unpublished observations were excluded.
  • The search identified 75 original studies measuring sweating rate and/or fluid balance during training or competition and 20 original studies measuring hypohydration effects on performance in team sport athletes.
  • Studies were summarized by sport and risk for hypohydration; performance outcomes were grouped into cognition, sport-specific skill, sprinting, lateral movements, jumping/anaerobic power, and intermittent high-intensity running capacity, with modifying factors tabulated.

Limitations

  • The paper states that a common limitation is difficulty blinding subjects to dehydration versus rehydration; many cognitive tests were not sport-specific (except one field hockey study), and validity/reliability of skill tests was not reported in basketball, tennis, and cricket studies. It also notes few studies included female or youth athletes, and no studies directly compared modifying factors such as sex, age, or athlete caliber.
  • The paper states that control trials varied in the degree of BML accrued, making cross-study comparison difficult, and that most studies involved only low-to-moderate hypohydration.
  • Evident from the text: this is a narrative review without pooled effect sizes; protocols, dehydration methods, BML differences, environmental conditions, and performance tests were heterogeneous, and many included studies had small samples.

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Integrity signals

Registry

Crossref · 10.1007/s40279-017-0738-7

Cites

182 of 182 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1 Venn diagram showing risk levels for the development of significant hypohydration (>2% body mass loss). The factors shown in this diagram elevate risk of hypohydration by increasing sweat loss (intensity and environment) or limiting fluid replacement. Note that “hot/humid environment” can include wearing protective equipment (which would create a hot/humid microclimate via encapsulation), as well as hot/humid ambient conditions. This diagram applies to the typical duration of team sports practice/competition, which is generally 1–2 h. In instances of shorter or longer duration, risk level may decrease or increase, respectively. Various team sports can be generally classified into low, moderate, and high risk based upon how the structure/rules of the game impact the three risk factors. However, on an individual basis, risk of hypohydration may shift to a lower or higher category depending upon various factors such as drinking behavior (e.g., cultural/social factors), playing position (e.g., soccer goalie vs. midfielder, or baseball catcher vs. outfielder), and playing time (e.g., reserve vs. starter). In addition, for outdoor sports the risk may shift depending upon time of day and season of the year that training/competition takes place (i.e., due to differences in temperature/humidity throughout the day/year)
Fig. 1 Venn diagram showing risk levels for the development of significant hypohydration (>2% body mass loss). The factors shown in this diagram elevate risk of hypohydration by increasing sweat loss (intensity and environment) or limiting fluid replacement. Note that “hot/humid environment” can include wearing protective equipment (which would create a hot/humid microclimate via encapsulation), as well as hot/humid ambient conditions. This diagram applies to the typical duration of team sports practice/competition, which is generally 1–2 h. In instances of shorter or longer duration, risk level may decrease or increase, respectively. Various team sports can be generally classified into low, moderate, and high risk based upon how the structure/rules of the game impact the three risk factors. However, on an individual basis, risk of hypohydration may shift to a lower or higher category depending upon various factors such as drinking behavior (e.g., cultural/social factors), playing position (e.g., soccer goalie vs. midfielder, or baseball catcher vs. outfielder), and playing time (e.g., reserve vs. starter). In addition, for outdoor sports the risk may shift depending upon time of day and season of the year that training/competition takes place (i.e., due to differences in temperature/humidity throughout the day/year)CC BY · PubMed Central
Fig. 2 Venn diagram showing the likelihood of performance impairment with hypohydration. Based on the studies reviewed, the likelihood of performance impairment seems to increase with higher levels of hypohydration and heat stress. The circle with the dashed line represents other factors that may play a role, but require more research in team sports; these include high aerobic demand, hypohydration at baseline, and individual differences in the response to hypohydration (e.g., low cognitive resiliency). BML body mass loss
Fig. 2 Venn diagram showing the likelihood of performance impairment with hypohydration. Based on the studies reviewed, the likelihood of performance impairment seems to increase with higher levels of hypohydration and heat stress. The circle with the dashed line represents other factors that may play a role, but require more research in team sports; these include high aerobic demand, hypohydration at baseline, and individual differences in the response to hypohydration (e.g., low cognitive resiliency). BML body mass lossCC BY · PubMed Central

Verification

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Citations

Cites

Research works printed but not linked: 3

  1. Baker LB, Barnes KA, Anderson ML, et al. Normative data for regional sweat sodium concentration and whole-body sweating rate in athletes. J Sports Sci. 2015;12:1–11.
  2. Pyke FS, Hahn AG. Body temperature regulation in summer football. Sports Coach. 1980;4:41–3.
  3. Portus M, Timms S, Spratford W, et al. The utility of a bowling skills test to assist developing fast bowlers. In: Portus M, editor. Conference proceedings from Conference of science, medicine, and coaching. Brisbane: Cricket Australia; 2010. p. 137–40.

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Metadata

Authors
Nuccio, R. P., Barnes, K. A., Carter, J. M., & Baker, L. B.
Affiliations
Gatorade Sports Science Institute (US)
Corresponding author
Nuccio, Ryan P.
ORCID
Venue
Sports Medicine
Publisher
Springer Science and Business Media LLC
Published
2017-05-15
Volume
47
Issue
10
Pages
1951-1982
ISSN
  • 0112-1642 (ISSN-L)
  • 1179-2035
DOI
10.1007/s40279-017-0738-7
PMC
PMC5603646
OpenAlex
W2613635638
Cited by
252
References
183
Citations by year
2026: 30 · 2025: 28 · 2024: 26 · 2023: 30 · 2022: 31 · 2021: 41 · 2020: 36 · 2019: 18 · 2018: 10 · 2017: 2
FWCI
2.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Sports Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by)
Funders
Gatorade Sports Science Institute
Topics
  • Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords
hypohydration, fluid balance, team sport athletes, sweat loss, weight loss, soccer, hydration status, cognitive performance, technical performance, physical performance, heat stress, fatigue, perceived exertion, hydration protocol
MeSH terms
Adolescent, Adult, Cognition, Dehydration, Female, Humans, Male, Sports, Water-Electrolyte Balance, Reproducibility of Results, Athletic Performance, Athletes

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