Exercise and Fluid Replacement

Michael N. Sawka, FACSM; Louise M. Burke, FACSM; E. Randy Eichner, FACSM; Ronald J. Maughan, FACSM; Scott J. Montain, FACSM; Nina S. Stachenfeld, FACSM


March 02, 2010

In This Article


Physical exercise can elicit high sweat rates and substantial water and electrolyte losses, particularly in warm-hot weather. If sweat water and electrolyte losses are not replaced then the individual will dehydrate during physical activity. Excessive dehydration can degrade exercise performance and increase risk of exertional heat illness. Overdrinking can lead to symptomatic exercise-associated hyponatremia. Women and older adults may be at greater risk for fluid-electrolyte imbalances during and after vigorous exercise.

The goal of prehydrating is to start of physical activity euhydrated and with normal body electrolyte status. Prehydrating with beverages should be initiated at least several hours before exercise to enable fluid absorption and allow urine output to return to normal levels. The goal of drinking during exercise is to prevent excessive (>2% body weight loss from water deficit) dehydration and excessive changes in electrolyte balance from compromising performance and health. Because there is considerable variability in sweating rates and composition between individuals, individualized fluid replacement programs are recommended. Measurement of pre- and postexercise body weight to determine sweat rates is a simple and valid approach to estimate sweat losses. During exercise, consuming beverages containing electrolytes and carbohydrates can provide benefits over water along under certain circumstances. After exercise, the goal is to replace fluid and electrolyte deficits. The speed with which rehydration is needed and the magnitude of fluid/electrolyte deficits will determine if an aggressive replacement program is merited.