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METHODS: 318 collegiate athletes (193 female) provided blood and urine samples and asked to rate how thirsty they were on a 10-point visual analogue scale. Serum was analyzed for serum [Na] while urine osmolality was measured using an osmometer. USG was measured using a Chemstrip. Data were categorized into Dehydrated versus Hydrated groupings based upon the above-mentioned UOsm and USG thresholds. RESULTS: Athletes from seven sports teams were represented (combined: height 1.75±0.1m; weight 71.9±13.5kg; body mass index 23.2±2.5kg/m). Overall, female athletes had lower USG vs. male athletes (1.014±0.006 vs. 1.015±0.006;p=0.03). Using the UOsm ≥700mOsmol/kgH 2 O threshold to define dehydration, 55% of athletes were classified as dehydrated. Using any USG ≥1.020 to define dehydration, 27% of these same athletes were classified as dehydrated. No athlete met the clinical definition for dehydration (hypertonicity; serum [Na] >145mmol/L). Normonatremia (serum [Na] between 135-145mmol/L) was maintained in 99.7% of athletes (mean serum [Na] 139.9±2.1; range 134-145mmol/L) despite wide variation in UOsm (mean 682.7±302; range 110-1298mOsmol/kgH 2 O). A significant correlation was confirmed between serum [Na] versus UOsm (r=0.18; p=0.001). However, urine concentration at the extreme ranges of dehydration did not reflect clinical abnormalities in serum markers or thirst rating (mean rating 4.4±1.8; range 0-10). CONCLUSION: Urine concentration thresholds (commonly used by sports medicine) classified 27-55% of collegiate athletes as dehydrated, while no athlete was dehydrated according to serum [Na] measurement. Practitioners should caution against using urine indices, as isolated measurements, to diagnose or monitor dehydration because urinary output is largely a response rather than a reflection of physiologically regulated blood tonicity.

Thirst Perception and Fluid Intake are not Affected by Knowledge of Water Losses During Exercise