Prolonged exercise following diuretic-induced hypohydration effects on fluid and electrolyte hormones.

To investigate the hypothesis that a reduction in plasma volume (PV) induced by diuretic administration would result in an increase in the fluid and electrolyte hormonal response to exercise, ten untrained males (VO(2) peak = 3.96 +/- 0.14 l/min) performed 60 min of cycle ergometry at 61 % VO(2) peak twice. The test was carried out once under control conditions (CON) (placebo) and once after 4 days of diuretic administration (DIU) (Novotriamazide; 100 mg triamterene and 50 mg hydrochlorothiazide). Calculated resting PV decreased by 14.6 +/- 3.3 % (p < 0.05) with DIU. No difference in plasma osmolality was observed between conditions. For the hormones measured, differences (p < 0.05) between conditions at rest were noted for plasma renin activity (PRA) (0.62 +/- 0.09 vs. 5.61 +/- 0.94 ng/ml/h), angiotensin I (ANG 1) (0.26 +/- 0.03 vs. 0.56 +/- 0.08 ng/ml), aldosterone (ALD) (143 +/- 14 vs. 1603 +/- 302 pg/ml), arginine vasopressin (AVP) (4.13 +/- 1.1 vs. 9.58 +/- 1.6 pg/ml) and atrial natriuretic peptide (alpha-ANP) (11.5 +/- 2.8 vs. 6.33 +/- 1.0 pg/ml). The exercise resulted in increases (p < 0.05) in PRA, ANG I, ALD, AVP, alpha-ANP. DIU led to higher levels of PRA, ANG I, and ALD (p < 0.05) and lower levels of alpha-ANP (p < 0.05) compared to CON. Arginine vasopressin was not affected by the loss of PV. For the catecholamines--norepinephrine (NE) and epinephrine (EPI)--only NE was higher during exercise with DIU compared to CON (p < 0.05). For PRA and ALD, the higher levels observed during exercise with DIU could be explained both by higher resting levels and a greater increase during exercise itself. For ANG I and NE, the effect of DIU only manifested itself during exercise. In contrast, the lower alpha-ANP observed during exercise with DIU was due to the lower resting levels. These results support the hypotheses that hypohydration leads to alterations in the secretion of all of the fluid and electrolyte hormones with the exception of AVP. The specific mechanisms of these alterations remain unclear, but appear to be related directly to the decrease in PV.     

Prolonged exercise after diuretic-induced hypohydration: effects on substrate turnover and oxidation

To determine the influence of a diuretic-induced reduction in plasma volume (PV) on substrate turnover and oxidation, 10 healthy young males were studied during 60 min of cycling exercise at 61% peak oxygen uptake on two separate occasions > or =1 wk apart. Exercise was performed under control conditions (CON; placebo), and after 4 days of diuretic administration (DIU; Novotriamazide; 100 mg triamterene and 50 mg hydrochlorothiazide). DIU resulted in a calculated reduction of PV by 14.6 +/- 3.3% (P < 0.05). Rates of glucose appearance (R(a)) and disappearance (R(d)) and glycerol R(a) were determined by using primed constant infusions of [6,6-(2)H]glucose and [(2)H(5)]glycerol, respectively. No differences in oxygen uptake during exercise were observed between trials. Main effects for condition (P < 0.05) were observed for plasma glucose and glycerol, such that the values observed for DIU were higher than for CON. No differences were observed in plasma lactate and serum free fatty acid concentrations either at rest or during exercise. Hypohydration led to lower (P < 0.05) glucose R(a) and R(d) at rest and at 15 and 30 min of exercise, but by 60 min, the effects were reversed (P < 0. 05). Hypohydration had no effect on rates of whole body lipolysis or total carbohydrate or fat oxidation. A main effect for condition (P < 0.05) was observed for plasma glucagon concentrations such that larger values were observed for DIU than for CON. A similar decline in plasma insulin occurred with exercise in both conditions. These results indicate that diuretic-induced reductions in PV decreases glucose kinetics during moderate-intensity dynamic exercise in the absence of changes in total carbohydrate and fat oxidation. The specific effect on glucose kinetics depends on the duration of the exercise.     

Some observations on the effects of heat,exercise and hypohydration upon involuntary hypohydration in man

Four male subjects at a high level of physical fitness were put on a controlled diet 4 days prior to a 4-hr exposure in a hot room(49°C) in separate experiments at rest or with exercise on a treadmill and free or no access to drinking water.The experiments were repeated at 24°C.Each experiment was followed by a recovery period of 8 hr. The water intake during the heat exposure was roughly proportional to the work load. The rate of water consumption during the recovery period was independent of the level of hypohydration. Previously hypohydrated men took longer to regain their water debt than previously hydrated men.

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Zusammenfassung Vier gut tränierte Personen wurden nach 4 Tagen Ernährung mit einer Kontrolldiät 4 Stunden in einer Klimakammer bei 49°C in Ruhe oder mit Belastung (Laufband)mit oder ohne Wasser zum Trinken exponiert.Die Werte wurden verglichen mit dem Verhalten der gleichen Personen bei 24°C. Den Exponierungsversuchen folgte eine Erholungsperiode von 8 Stunden bei 24°C. Die Wasserbedarf während der Hitzeexponierung war ungefähr proportional der körperlichen Leistung. Die Geschwindigkeit der Wasseraufnahme in der Erholungsphase war unabhängig von den Ausmass der Hypohydration. Die Auffüllung der Wasserschuld dauerte mehrere Stunden. Unabhängig von der Ausmass der Wasserschuld stieg die Wasseraufnahme während der Mahlzeiten an.

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Resume Après avoir été mis durant 4 jours à une diète contrôlée, 4 personnes bien entraînées ont été placées dans une chambre climatisée. Ces personnes y restèrent durant 4 hr par 49°C avec ous sans eau à boire, soit au repos,soit en effectuant un effort (roue). On a alors comparé les résultats obtenus à ceux des mêmes personnes soumises aux mêmes épreuves, mais par 24°C. Les expositions au chaud furent suivies de périodes de repos de 8 hr par 24°C. Les besoins en eau furent, lors des essais, environ proportionnels à l'effort fourni. La rapidité avec laquelle l'eau fut absorbée pendant la phase de récupération fut indépendante du degré de déshydratation. La compensation du déficit hydrique dura plusieurs heures. Indépendemment de l'importance du déficit hydrique, on a constaté une augmentation de la consommation en eau durant les repas.

     

Gastric emptying during exercise: effects of heat stress and hypohydration

To determine the effects of acute heat stress, heat acclimation and hypohydration on the gastric emptying rate of water (W) during treadmill exercise, ten physically fit men ingested 400 ml of W before each of three 15 min bouts of exercise (treadmill, approximately 50% VO2max) on five separate occasions. Stomach contents were aspirated after each exercise bout. Before heat acclimation (ACC), experiments were performed in a neutral (18 degrees C), hot (49 degrees C) and warm (35 degrees C) environment. Subjects were euhydrated for all experiments before ACC. After ACC, the subjects completed two more experiments in the warm (35 degrees C) environment; one while euhydrated and a final one while hypohydrated (-5% of body weight). The volume of ingested water emptied into the intestines at the completion of each exercise bout was inversely correlated (P less than 0.01) with the rectal temperature (r = -0.76). The following new observations were made: 1) exercise in a hot (49 degrees C) environment impairs gastric emptying rate as compared with a neutral (18 degrees C) environment, 2) exercise in a warm (35 degrees C) environment does not significantly reduce gastric emptying before or after heat acclimation, but 3) exercise in a warm environment (35 degrees C) when hypohydrated reduces gastric emptying rate and stomach secretions. Reductions in gastric emptying appear to be related to the severity of the thermal strain induced by an exercise/heat stress.     

Thermal and circulatory responses during exercise: effects of hypohydration, dehydration, and water intake

Armstrong, Lawrence E., Carl M. Maresh, Catherine V. Gabaree, Jay R. Hoffman, Stavros A. Kavouras, Robert W. Kenefick, JohnW. Castellani, and Lynn E. Ahlquist. Thermal and circulatory responses during exercise: effects of hypohydration, dehydration, andwater intake. J. Appl. Physiol. 82(6):2028-2035, 1997.This investigation examined the distinct andinteractive effects of initial hydration state, exercise-induceddehydration, and water rehydration in a hot environment. On fouroccasions, 10 men performed a 90-min heat stress test (treadmillwalking at 5.6 km/h, 5% grade, 33°C, 56% relative humidity).These heat stress tests differed in pretest hydration [2euhydrated (EU) and 2 hypohydrated (HY) trials] and water intakeduring exercise [2 water ad libitum (W) and 2 no water (NW)trials]. HY + NW indicated greater physiological strain than allother trials (P < 0.05-0.001)in heart rate, plasma osmolality(P_osm), sweat sensitivity(g / °C · min), and rectal temperature.Unexpectedly, final HY + W and EU + W responses for rectal temperature,heart rate, and P_osm were similar,despite the initial 3.9 ± 0.2% hypohydration in HY + W. Weconcluded that differences in pretestP_osm (295 ± 7 and 287 ± 5 mosmol/kg for HY + W and EU + W, respectively) resulted in greaterwater consumption (1.65 and 0.31 liter for HY + W and EU + W,respectively), no voluntary dehydration (0.9% body mass increase), andattenuated thermal and circulatory strain during HY + W.

     

Hydration during exercise. Effects on thermal and cardiovascular adjustments

Five young unacclimatised subjects were exposed for 4 h at 34 degrees C (10 degrees C dew-point temperature and 0.6 m X s-1 air velocity), while exercising on a bicycle ergometer: 25 min work--5 min rest cycles for 2 hours followed by 20 min work--10 min rest cycles for two further hours. 5 experimental sessions were carried out: one without rehydration (NO FLUID) resulting in 3.1% mean loss of body weight (delta Mb), and four sessions with 20 degrees C fluid ingestion of spring water (WATER), hypotonic (HYPO), isotonic (ISO) and hypertonic (HYPER) solutions to study the effects of fluid osmolarity on rehydration. Mean final rehydration (+/- SE) after fluid intake was 82.2% (+/- 1.2). Heart rate was higher in NO FLUID while no difference among conditions was found in either delta Mb or hourly sweat rates. Sweating sensitivity was lowest in the dehydration condition, and highest in the WATER one. Modifications in plasma volume and osmolarity demonstrated that NO FLUID induced hyperosmotic hypovolemia, ISO rehydration rapidly led to plasma isoosmotic hypervolemia, while WATER led to slightly hypoosmotic normovolemia. It is concluded that adequate rehydration through ingestion of isotonic electrolyte-sucrose solution, although in quantities much smaller than evaporative heat loss, rapidly restored and expanded plasma volume. While osmolarity influenced sweating sensitivity, the plasma volume changes (delta PV) within the range -6% less than or equal to delta PV + 4% had little effect on temperature adjustments in our conditions.     

Effect of hypohydration on gastric emptying and intestinal absorption during exercise

Dehydration and hyperthermia may impair gastricemptying (GE) during exercise; the effect of these alterations onintestinal water flux (WF) is unknown. Thus the purpose of this studywas to determine the effect of hypohydration (~2.7% body weight) on GE and WF of a water placebo (WP) during cycling exercise (85 min, 65%maximal oxygen uptake) in a cool environment (22°C) and to alsocompare GE and WF of three carbohydrate-electrolyte solutions (CES)while the subjects were hypohydrated. GE and WF were determined simultaneously by a nasogastric tube placed in the gastric antrum andvia a multilumen tube that spanned the duodenum and the first 25 cm ofjejunum. Hypohydration was attained 12-16 h before experiments bylow-intensity exercise in a hot (45°C), humid (relative humidity 50%) environment. Seven healthy subjects (age 26.7 ± 1.7 yr,maximal oxygen uptake 55.9 ± 8.2 ml · kg¹ · min¹)ingested either WP or a 6% (330 mosmol), 8% (400 mosmol), or a 9%(590 mosmol) CES the morning following hypohydration. For comparison,subjects ingested WP after a euhydration protocol. Solutions (~2.0liters total) were ingested as a large bolus (4.6 ml/kg body wt) 5 minbefore exercise and as small serial feedings (2.3 ml/kg body wt) every10 min of exercise. Average GE rates were not different amongconditions (P > 0.05). Mean(±SE) values for WF were also similar(P > 0.05) for the euhydration (15.3 ± 1.7 ml · cm¹ · h¹)and hypohydration (18.3 ± 2.6 ml · cm¹ · h¹)experiments. During exercise after hypohydration, waterabsorption was greater (P < 0.05)with ingestion of WP (18.3 ± 2.6) and the 6% CES (16.5 ± 3.7),compared with the 8% CES (6.9 ± 1.5) and the 9% CES (1.8 ± 1.7). Mean values for final core temperature (38.6 ± 0.1°C),heart rate (152 ± 1 beats/min), and change in plasma volume(5.7 ± 0.7%) were similar among experimental trials. Weconclude that 1) hypohydration to~3% body weight does not impair GE or fluid absorption duringmoderate exercise when ingesting WP, and2) hyperosmolality (>400 mosmol)reduced WF in the proximal intestine.

     

Thermoregulatory and blood responses during exercise at graded hypohydration levels

We studied the effects of graded hypohydration levels on thermoregulatory and blood responses during exercise in the heat. Eight heat-acclimated male subjects attempted four heat-stress tests (HSTs). One HST was attempted during euhydration, and three HSTs were attempted while the subjects were hypohydrated by 3, 5, and 7% of their body weight. Hypohydration was achieved by an exercise-heat regimen on the day prior to each HST. After 30 min of rest in a 20 degrees C antechamber the HST consisted of a 140-min exposure (4 repeats of 10 min rest and 25 min treadmill walking) in a hot-dry (49 degrees C, 20% relative humidity) environment. The following observations were made: 1) a low-to-moderate hypohydration level primarily reduced plasma volume with little effect on plasma osmolality, whereas a more severe hypohydration level resulted in no further plasma volume reduction but a large increment in plasma osmolality; 2) core temperature and heart rate responses increased with severity of hypohydration; 3) sweating rate responses for a given rectal temperature were systematically decreased with severity of hypohydration; and 4) the reduction in sweating rate was more strongly associated with plasma hyperosmolality than hypovolemia. In conclusion, an individual's thermal strain increases linearly with the severity of hypohydration during exercise in the heat, and plasma hyperosmolality influences the reduction in sweating more profoundly than hypovolemia.     

The cardiac filling pressure following exercise and thermal stress

Under heat stress, a decrease of the central venous pressure (CVP) was regularly observed, raising the question of whether this reaction is a limiting factor for the circulation. In animal experiments it could be shown, however, that despite a lowered CVP, which depended on the elevated body temperatures, a high cardiac output (CO), as well as an elevated stroke volume could be maintained. A low CVP went hand in hand with a low total peripheral resistance. It was argued that under these circumstances the low CVP was not limiting because the intrinsic factors of the heart (sympathetic stimulation) were capable of maintaining a high CO. In human experiments the lowered CVP had to be seen in relation to the degree of dehydration. Regardless of whether the plasma volume remained constant, as in exercise, or declined, as in thermal stress (sauna), the CVP followed the volume depletion of the vascular and extravascular space, and it might well be that under these circumstances CVP is limiting. In this case, however, the altered CVP must be seen first as a monitor for the fluid deficit and not as a factor controlling cardiac function.     

Central cardiovascular and thermal effects of prostacyclin in rats

Prostacyclin (PGI₂) induced a dose-dependent decrease in blood pressure with slight increases in heart rate and body temperature, when administered at the doses of 0.1–100 μg into the lateral cerebral ventricle (i.c.v.) of the urethane-anaesthetised rat. When the same doses were administered intravenously, both the blood pressure and heart rate decreased. Central pretreatment with sodium meclofenamate (1 mg/rat i.c.v.) antagonised the central hypotensive effect of PGI₂ but i.c.v. pretreatment of the rats with indomethacin (1 mg/rat) failed to affect the PGO₂-induced hypotension. Central pretreatment with two histamine H₂-receptor antagonists, cimetidine (500 μg/rat i.c.v.) or metiamide (488 μg/rat i.c.v.), antagonised the blood pressure lowering effect of 0.1 μg dose of PGI₂ but failed to affect the hypotension induced by higher PGI₂ doses. Therefore the main central hypotensive effect of PGI₂ seems not to be associated with the stimulation of histamine H₂ -receptors in the brain.The hypotensive effect of i.c.v. administered PGI₂ appears to be due to an action upon the central nervous system rather than to a leakage into the peripheral circulation. This assumption is supported by the fact that sodium meclofenamate i.c.v. antagonished the effect of PGI₂. In addition, the chronotropic response to i.c.v. PGI₂ was opposite to that induced by intravenous administration. The results also suggest that there may be differences in the mode of action between sodium meclofenamate and indomethacin.     

Differential effects of sauna-, diuretic-, and exercise-induced hypohydration

The physiological effects on submaximal and maximal exercise of three methods commonly used by athletes for achieving rapid weight loss were determined by measuring cardiorespiratory variables in 62 nonendurance athletes. A mean weight loss of 4.1% was achieved by those who followed either a sauna (SAU), diuretic (DIU), or exercise (ACT) protocol, compared with the average weight loss of 1.2% in the control group. At maximal exercise O2 consumption, O2 pulse, blood lactate concentration, and work load decreased in SAU and DIU groups relative to the ACT group, whereas only a few differences were observed at the aerobic threshold. Weight loss achieved over a 48-h period was less detrimental to an athlete than was a more rapid (24-h) weight reduction achieved through sauna bathing or the use of diuretics. We conclude that not only the quantity of weight loss but also the method itself may limit physical performance.     

The effects of progressive exercise on cardiovascular function in elite athletes: focus on oxidative stress

Some side-effects of excessive physical training are ascribed to reactive oxygen species production. In this work we investigated the effects of progressively imposed maximal physical effort (levels I to V), using progressive maximal exercise test, on peripheral blood lactate, NO (through NO2-), superoxide anion (O2-) and methemoglobin (MetHb) in a group of 19 elite soccer players. Blood lactate (mmol/L) was increased (4.55, level V vs. resting level, 1.95). The basal production of NO2- was in the direct relation with O2 consumption. Significant increase (p<0.05) in O2- values at effort level I (4.18) as compared to the resting value (4.01), and the significant increase (p<0.01 or p<0.05) in the MetHb (%) was found between II (18.79) and III (19.63) or between II and IV (19.24) effort levels, respectively. The regression lines of NO2- and O2- crossed at the level of the respiratory compensation point (RC), suggesting that RC could be of a crucial importance not only in the anaerobic and aerobic metabolism but in mechanisms of signal transductions as well. The results could be of the theoretical interest and also useful in designing an athlete training strategy.     

Reactive oxygen species in pregnant rats: effects of exercise and thermal stress

With the aim of evaluating the effect of interaction between physical training or exercise only during pregnancy and thermal stress on oxidative stress, and antioxidant mechanism sedentary pregnant rats (PS), exercised pregnant rats only during pregnancy (PE) and trained rats submitted to also exercise during pregnancy (PT) were compared (N=63). Exercise sessions consisted of swimming at 80% of maximal work load supported into water at 28 degrees C (hypothermia, PS 28, PE28, PT28) or 35 degrees C (thermal neutrality, PS35, PE35, PT35) or 39 degrees C (hyperthermia, PS39, PE39, PT39), for 30 min. The initial body weight in all groups of rats was from 177 to 207 g. On the 20th day of pregnancy, 24 h after the last immersion or swimming session venous blood was collected to determine oxidative stress. Plasma concentrations of means malondialdehyde (MDA) values measured as thiobarbituric acid reactive substances (TBARS); total glutathione (GSH) and vitamin E were determined. The oxidative stress index was calculated from the ratio TBARS/GSH and TBARS/Vitamin E. TBARS did not change on the group PE at different temperatures of water; TBARS were higher for PS28 than PS35 and PS39; PT35 had higher values than PT28 and PT39. For GSH, PS39 was lower than PS35; PE28 was higher than PE35 and PE39 and PT35 were lower than PT28 and PT39. Plasma concentration of vitamin E did not present any difference for sedentary rats at different water temperatures, but for PE28, the values were lower than for PE35 and PE39, whereas PT39 was lower than PT35 and PT28. In relation to TBARS/GSH, it was verified an increase in oxidative stress for PS28 (in relation to PS35 and PS39), PE35, and PT35 (in relation to PE28 and PE39 or PT28 and PT39); regarding the ratio TBARS/vitamin E, the highest values were obtained at 35 degrees C for PS and PT groups and at 39 for PE group. These results have shown the great complexity of the interaction between physical training, thermal stress and pregnancy. Apparently, hypothermia produces large index of oxidative stress only in sedentary rats, but this index was greater at 35 degrees C in relation to extreme temperatures for trained rats. These results have suggested that physical training allows a more efficient activation of antioxidant mechanisms under thermal stress.