The Role of Water Homeostasis in Muscle Function and Frailty: A Review
Open accessAbstract
Water, the main component of the body, is distributed in the extracellular and intracellular compartments. Water exchange between these compartments is mainly governed by osmotic pressure. Extracellular water osmolarity must remain within very narrow limits to be compatible with life. Older adults lose the thirst sensation and the ability to concentrate urine, and this favours increased extracellular osmolarity (hyperosmotic stress). This situation, in turn, leads to cell dehydration, which has severe consequences for the intracellular protein structure and function and, ultimately, results in cell damage. Moreover, the fact that water determines cell volume may act as a metabolic signal, with cell swelling acting as an anabolic signal and cell shrinkage acting as a catabolic signal. Ageing also leads to a progressive loss in muscle mass and strength. Muscle strength is the main determinant of functional capacity, and, in elderly people, depends more on muscle quality than on muscle quantity (or muscle mass). Intracellular water content in lean mass has been related to muscle strength, functional capacity, and frailty risk, and has been proposed as an indicator of muscle quality and cell hydration. This review aims to assess the role of hyperosmotic stress and cell dehydration on muscle function and frailty.
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Exercising in a dehydrated state negatively affects both performance and health.
“Exercising in a dehydrated state is well-established to negatively affect both performance and health [97, 98].”
From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [97]
Section 7 (Dehydration in the Elderly; page unavailable) links dehydration with reduced muscle strength and adverse health outcomes in older adults. Section 10 (Water’s Role in Metabolic Muscle Function; page unavailable) says water loss can affect muscle function. Neither establishes that exercising while dehydrated negatively affects both performance and health, particularly as a well-established general finding. (LLM, conf=0.84)
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- Authors
- Lorenzo, I., Serra-Prat, M., & Yébenes, J. C.
- Affiliations
- Maresme Health Consortium (ES)
- Research Unit, Consorci Sanitari del Maresme, 08304 Mataró (Barcelona), Spain
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2019-08-09
- Volume
- 11
- Issue
- 8
- Pages
- 1857
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6723611
- OpenAlex
- W2969066781
- Cited by
- 239
- References
- 107
- Citations by year
- 2026: 31 · 2025: 45 · 2024: 68 · 2023: 40 · 2022: 18 · 2021: 21 · 2020: 16
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Spanish Ministry of Health (Instituto de Salud Carlos III) (FIS PI 16/00750)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Keywords
- water homeostasis, muscle function, frailty, hyperosmotic stress, cell dehydration, osmotic pressure, extracellular osmolarity, thirst, urine concentrating ability, aging, muscle quality, muscle strength, functional capacity, cell volume, intracellular water content, lean body mass
- MeSH terms
- Frailty, Organism Hydration Status, Animals, Body Composition, Energy Metabolism, Humans, Muscle Contraction, Osmotic Pressure, Water-Electrolyte Balance, Water-Electrolyte Imbalance, Muscle, Skeletal, Muscle Strength
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