Fluid intake behavior in athletes during typical training bouts.

BACKGROUND: Hydration habits during training may differ depending on sports mode and individual characteristics. The aim of this study was to assess fluid intake behavior in a wide sample of Italian athletes during their regular training. METHODS: Data on hydration habits during training were collected from a random sample of competitive athletes. Hydration strategies and personal characteristics were queried via questionnaire, including athletes' quantity and type of fluid ingested during a typical training bout, sport characteristics (e.g. mode and training duration), and whether their coach encouraged them to drink during trainings. RESULTS: Three hundred and fifty-two competitive athletes participated to the study; two hundred eighty-nine athletes correctly completed all survey items (age: 8-63 years, median: 21±13 years). Athletes were involved in international (3.1%), national (34.1%) and regional (44.9%) competitions. Median fluid intakes during training were 0.25 L/h; 150 athletes reported fluid intake below the median, whilst 23 athletes (6.5% of total sample) reported fluid intake at or above currently published exercise hydration guidelines (NATA and ACSM). Binary logistic regression indicated that the number of pauses to drink (B=0.771, P=0.000), duration of a typical training bout (B=-2.237, P=0.000), and a coach's encouragement to drink (B=0.601, P=0.030) were each associated with fluid consumption above or below the median value. CONCLUSIONS: Athletes across all disciplines reported drinking less fluid during training than currently espoused in hydration guidelines. A coach's encouragement to drink, the number of pauses during training, and bout duration each influence total fluid volume consumed, regardless of competition level, sex or the age of an athlete.

Management of exercise-induced glycemic imbalances in type 1 diabetes.

Regular moderate-intensity exercise is strongly recommended for its beneficial effects in all people. In patients with type 1 diabetes, however, the exercise-associated glycemic imbalances remain an unresolved clinical challenge. Current guidelines require an in-depth understanding of the glycemic responses to exercise and each patient has to discover, by trial-and-error, his/her own strategy, several attempts being usually required to gain sufficient experience. Consequently, fear of hypoglycemia remains the strongest barrier to physical activity. This paper explores the potential strategies that may be employed to minimize the risk of exercise related glycemic imbalances. Moreover, a newly developed algorithm (ECRES, Exercise Carbohydrate Requirement Estimating Software) is described, which estimates on a patient- and situation-specific basis the glucose supplement required by the patient to maintain safe blood glucose levels. The algorithm was tested on 27 patients who performed three 1-hr constant intensity walks (each starting at a different time interval following insulin injection). Results showed that in 70.4% of the trials, independent of the time of day, the algorithm provided a satisfactory estimate of the carbohydrates needed by patients to complete the exercise with a glucose level within safe thresholds (i.e. 3.9 - 10 mmol·L-1). Despite the algorithm requires further experimental testing to be applied by the majority of patients, these results indicate its potential usefulness as a tool for preventing immediate exercise-induced glycemic imbalances (i.e. during exercise) in type 1 diabetic patients, in particular for spontaneous activities not planned in advance, thus allowing all insulin-dependent patients to safely enjoy the benefits of exercise.