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Cited by 32Thermoregulation and physiological responsesSports Performance and TrainingCardiovascular and exercise physiology

The Effect of Pre-Exercise Hyperhydration on Exercise Performance, Physiological Outcomes and Gastrointestinal Symptoms: A Systematic Review

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Jardine, William T., Aisbett, Brad, Kelly, Monica K., Burke, Louise M., Ross, Megan L., Condo, Dominique, Périard, Julien D., Carr, Amelia J.·2023·Sports Medicine
DOI 10.1007/s40279-023-01885-2PMC PMC10587316
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Abstract

Background: Fluid loss during prolonged exercise in hot conditions poses thermoregulatory and cardiovascular challenges for athletes that can lead to impaired performance. Pre-exercise hyperhydration using nutritional aids is a strategy that may prevent or delay the adverse effects of dehydration and attenuate the impact of heat stress on exercise performance. Objectives: The aim of this systematic review was to examine the current literature to determine the effect of pre-exercise hyperhydration on performance, key physiological responses and gastrointestinal symptoms. Methods: English language, full-text articles that compared the intervention with a baseline or placebo condition were included. An electronic search of Medline Complete, SPORTDiscus and Embase were used to identify articles with the final search conducted on 11 October 2022. Studies were assessed using the American Dietetic Association Quality Criteria Checklist. Results: Thirty-eight studies involving 403 participants (n = 361 males) were included in this review (n = 22 assessed exercise performance or capacity). Two studies reported an improvement in time-trial performance (range 5.7–11.4%), three studies reported an improvement in total work completed (kJ) (range 4–5%) and five studies reported an increase in exercise capacity (range 14.3–26.2%). During constant work rate exercise, nine studies observed a reduced mean heart rate (range 3–11 beats min−1), and eight studies reported a reduced mean core temperature (range 0.1–0.8 °C). Ten studies reported an increase in plasma volume (range 3.5–12.6%) compared with a control. Gastrointestinal symptoms were reported in 26 studies, with differences in severity potentially associated with factors within the ingestion protocol of each study (e.g. treatment, dose, ingestion rate). Conclusions: Pre-exercise hyperhydration may improve exercise capacity during constant work rate exercise due to a reduced heart rate and core temperature, stemming from an acute increase in plasma volume. The combination of different osmotic aids (e.g. glycerol and sodium) may enhance fluid retention and this area should continue to be explored. Future research should utilise valid and reliable methods of assessing gastrointestinal symptoms. Furthermore, studies should investigate the effect of hyperhydration on different exercise modalities whilst implementing a strong level of blinding. Finally, females are vastly underrepresented, and this remains a key area of interest in this area.

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  • Rehydration strategies between exercise bouts recommend that athletes drink fluids equivalent to 125-150% of their body mass lost during exercise.

    “rehydration strategies between exercise bouts recommend that athletes drink fluids equivalent to 125–150% of their body mass lost during exercise [107, 108]”

    From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [108]

    The Introduction discusses pre-exercise hyperhydration to offset sweat loss, not rehydration between exercise bouts. Searches for between-bout rehydration and fluid replacement at 125–150% of body mass lost found no passage giving that recommendation. Page numbers were not available in our copy. (LLM, conf=0.75)

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Authors
Jardine, W. T., Aisbett, B., Kelly, M. K., Burke, L. M., Ross, M. L., Condo, D., Périard, J. D., & Carr, A. J.
Affiliations
  • Deakin University (AU)
  • Australian Catholic University (AU)
  • University of Canberra (AU)
Corresponding author
Jardine, William T.
ORCID
Venue
Sports Medicine
Publisher
Springer Science and Business Media LLC
Published
2023-07-25
Volume
53
Issue
11
Pages
2111-2134
ISSN
  • 0112-1642 (ISSN-L)
  • 1179-2035
DOI
10.1007/s40279-023-01885-2
PMC
PMC10587316
OpenAlex
W4385209176
Cited by
32
References
85
Citations by year
2026: 10 · 2025: 14 · 2024: 8
FWCI
1.14
Type
journal article
Language
en
Open access
Licence
Locations
  • Sports Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
Deakin University
Topics
  • Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
exercise performance, exercise capacity, gastrointestinal symptoms, plasma volume, core body temperature, heart rate, heat stress, dehydration, fluid retention, sodium, glycerol, fluid intake
MeSH terms
Dehydration, Gastrointestinal Diseases, Heart Rate, Hot Temperature, Humans, Exercise, Athletic Performance

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