Maintenance of water and electrolyte balance is important for sustaining cognitive and physical performance. Dehydration degrades morale and desire to work.<sup>1 Adolph E.F.   Physiology of Man in the Desert New York: Interscience (1947). 

Cliccare qui per andare alla sezione Riferimenti, 21 Eichna L.W., Bean W.B., Ashe W.F. , e al. Performance in relation to environmental temperature Bull Johns Hopkins Hosp 1945 ;  76 : 25-58

Cliccare qui per andare alla sezione Riferimenti</sup> Body water deficits of as little as 2% body weight can impair physical performance.<sup>8 Below P.R., Mora-Rodríguez R., González-Alonso J. , e al. Fluid and carbohydrate ingestion independently improve performance during 1 h of intense exercise Med Sci Sports Exerc 1995 ;  27 : 200-210

Cliccare qui per andare alla sezione Riferimenti, 74 Walsh R.M., Noakes T.D., Hawley J.A. , e al. Impaired high-intensity cycling performance time at low levels of dehydration Int J Sports Med 1994 ;  15 : 392-398  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Water deficits of 5% to 7% body weight are associated with dyspnea, headaches, dizziness, and apathy. Water deficit and salt depletion are also considered significant risk factors for the development of heat illness during hot-weather activities.<sup>66 Shapiro Y., Moran D., Epstein Y. Validation and adjustment of the mathematical prediction model for human sweat rate responses to outdoor environmental conditions Ergonomics 1995 ;  38 : 981-986  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Excessive overhydration can also be detrimental to cognitive and physical performance. People consuming excessive quantities of water during physical activities can produce a relatively rapid dilution of plasma electrolytes if the kidneys are unable to excrete the excess fluid. This behavior can result in intracranial swelling and development of “water intoxication”—a syndrome manifested by altered CNS function, nausea, and impaired physical abilities.<sup>5 Armstrong L.E., Curtis W.C., Hubbard R.W. , e al. Symptomatic hyponatremia during prolonged exercise in heat Med Sci Sports Exerc 1993 ;  25 : 543-549

Cliccare qui per andare alla sezione Riferimenti, 25 Frizzell R.T., Lang G.H., Lowance D.C. , e al. Hyponatremia and ultramarathon running JAMA 1986 ;  255 : 772-774  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 32 Hiller W.D.B., O'Toole M.L., Fortess E.E. , e al. Medical and physiological consideration in triathlons Am J Sports Med 1987 ;  15 : 164-167  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 48 Nelson P.B., Robinson A.G., Kapoor W. , e al. Hyponatremia in a marathon runner Physician and Sportsmedicine 1988 ;  16 : 78-87

Cliccare qui per andare alla sezione Riferimenti, 53 Noakes T.D., Goodwin N., Rayner B.L. , e al. Water intoxication: A possible complication during endurance exercise Med Sci Sports Exerc 1985 ;  17 : 370-375

Cliccare qui per andare alla sezione Riferimenti, 54 Noakes T.D., Norman R.J., Buck R.H. , e al. The incidence of hyponatremia during prolonged ultraendurance exercise Med Sci Sports Exerc 1990 ;  22 : 165-170

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This article summarizes the water and electrolyte losses during exercise and presents strategies to optimize hydration state before, during, and following exercise. This article is not an exhaustive review of the literature. The reader is referred to several excellent review articles<sup>17 Coyle E.F., Montain S.J. Carbohydrate and fluid ingestion during exercise: Are there tradeoffs? Med Sci Sports Exerc 1992 ;  24 : 671-678

Cliccare qui per andare alla sezione Riferimenti, 52 Noakes T.D. Fluid replacement during exercise  Baltimore: Williams & Wilkins (1993).  297-330

Cliccare qui per andare alla sezione Riferimenti, 64 Sawka M.N., Montain S.J., Latzka W.A. Body fluid balance during exercise-heat exposure Body Fluid Balance: Exercise and Sport Boca Raton: CRC Press (1996).  143-161

Cliccare qui per andare alla sezione Riferimenti, 68 Shi X., Gisolfi C.V. Fluid and carbohydrate replacement during intermittent exercise Sports Med 1998 ;  25 : 157-172  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> for more information on this topic. The American College of Sports Medicine also recently published a position stand on fluid replacement for exercise.<sup>3 American College of Sports Medicine Position stand on exercise and fluid replacement Med Sci Sports Exerc 1996 ;  28 : i-vii

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