title: Markers of the hydration process during fluid volume modification in women with habitual high or low daily fluid intakes.
abstract: OBJECTIVE
  Human daily total water intake (TWI) has a large inter-individual range. Recently, water supplementation has been suggested as a potential preventative and therapeutic modality. Thus, we aimed to measure hydration biomarkers in women with high (HIGH) versus low (LOW) daily TWI to determine baseline differences, and the efficacy of these markers during a systematic alteration in TWI.
  
  
  METHODS
  This cohort study identified 14 HIGH [3.34 (0.56) L day(-1)] and 14 LOW [1.62 (0.48) L day(-1)] from 120 women. Next, fluid intake was decreased in HIGH [2.00 (0.21) L day(-1)] while LOW increased [3.50 (0.13) L day(-1)] across 4 days. Body mass, fluid intake, serum osmolality (S osmo), total plasma protein (TPP), 24 h urine osmolality, and 24 h urine volume, were measured on each day of modified TWI. Estimated plasma volume (E pv) was calculated using measured body mass and hematocrit values.
  
  
  RESULTS
  At baseline, urinary markers and TPP differentiated HIGH from LOW [7.0 (0.3) versus 7.3 (0.3) mg dL(-1), respectively]. Upon TWI intervention, (1) body mass decreased in HIGH [-0.7 (1.1) kg, p = 0.010)] but did not increase in LOW [+0.0 (0.6) kg, p = 0.110], (2) E pv decreased 2.1 (2.4) %, p = 0.004, (3) urine osmolality increased in HIGH [397 (144)-605 (230) mOsm kg(-1), p < 0.001] and decreased in LOW [726 (248)-265 (97) mOsm kg(-1) p < 0.001], and (4) no changes of serum osmolality occurred in either HIGH or LOW (all p > 0.05).
  
  
  CONCLUSIONS
  Urinary markers and TPP are sensitive measures to habitual high and low TWI and to changes in TWI. Both groups through urinary and some hematological responses following TWI manipulation achieved regulation of hemoconcentration.
authors.affiliation: Department of Health, Human Performance, and Recreation, University of Arkansas, 155 Stadium Dr, Fayetteville, AR, 72701, USA, johnsone@uark.edu.
authors.forename: Evan C
authors.initials: EC
authors.lastname: Johnson
authors.forename: Colleen X
authors.initials: CX
authors.lastname: Muñoz
authors.forename: Laurent
authors.initials: L
authors.lastname: Le Bellego
authors.forename: Alexis
authors.initials: A
authors.lastname: Klein
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Casa
authors.forename: Carl M
authors.initials: CM
authors.lastname: Maresh
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D015415:Biomarkers; D015331:Cohort Studies; D003681:Dehydration / Q000097:blood* / Q000652:urine; D004326:Drinking / Q000502:physiology*; D005260:Female; D006801:Humans; D010953:Plasma Volume / Q000502:physiology; D014882:Water-Electrolyte Balance / Q000502:physiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers