Oral rehydration beverages for treating exercise-associated dehydration: a systematic review.Part I: carbohydrate-electrolyte solutions.

Abstract

Exercise-associated dehydration is a common problem, especially at sporting events. Although there are recommendations to drink a certain volume per kg body mass lost after exercise, there is no clear guidance about the type of rehydration beverage. The aim of this systematic review is to assess the effectiveness of carbohydrate-electrolyte solutions as a rehydration solution for exercise-associated dehydration. Medline (via the PubMed interface), Embase and the Cochrane Library were searched for relevant studies. The search is up to date until June 2022. Controlled trials involving adults and children were included if dehydration was the result of physical exercise and if drinking carbohydrate-electrolyte solutions, of any percentage carbohydrate, was compared with drinking water. All languages were included as long as an English abstract was available. Data on study design, study population, interventions, outcome measures and study limitations were extracted from each included article. Certainty was assessed using GRADE. Out of 3485 screened articles, 19 studies were included that assessed carbohydrate-electrolyte solutions (0% - 9% carbohydrate) compared with water. Although there is variability amongst the identified studies, drinking 0-3.9% and, especially, 4-9% carbohydrate-electrolyte (CE) solution may be effective for rehydration. A potential beneficial effect of drinking CE drinks compared with water was seen for many of the reviewed outcomes. Commercial CE drinks (ideally 4-9% CE drinks or alternatively 0-3.9% CE drinks) could be suggested for rehydration in persons with exercise associated dehydration when whole foods are not available.