Subjective vs. Objective Urine Color: Effect of Hydration Status

Abstract Background An adequate hydration status is critical to ensure efficiency during mental and physical activities. Our goal was to assess the hydration status of a Spanish group of aeronautical military men and to determine the association of hydration status with body composition and anxiety. Methods A total of 188 men were evaluated through a validated hydration questionnaire, anthropometric and biochemical parameters, and an anxiety questionnaire. Based on these methods, the criteria of hydration were established. Results Of the total sample, 81% met the hydration criteria (urine color = well hydrated, water balance ≥ 0 ml, and total water intake/weight ≥ 35 ml/kg), and 19% did not meet the hydration criteria (urine color = not sufficiently hydrated or dehydrated, water balance < 0 ml, and total water intake/weight < 35 ml/kg). Subjects not meeting the hydration criteria had lower urine pH, negative water balance, and lower water intake. The latter also had higher anxiety status (score = 4 vs. 3, P = 0.026), weight [(84.7 ± 10.5) vs. (80.5 ± 10.2) kg], body mass index [(26.3 ± 3.1) vs. (25.2 ± 2.8)]kg/m2, body fat [(22.3 ± 5.6) vs. (18.3 ± 6.5)] %, urine specific gravity, and urine color. Using a logistic binary regression model, hydration status was related significantly with the percentage of body fat (P = 0.004), but no relation was found with age, comorbidities, or medications. Furthermore, total water intake/weight was positively correlated with percentage of body water (r = 0.357, P = 0.000) and negatively with body fat (kg) (r = − 0.427, P = 0.000), percentage of body fat (r = − 0.405, P = 0.000), and waist/hip ratio (r = − 0.223, P = 0.002). Based on a linear regression model, total water intake/weight was related significantly with percentage of body fat (P = 0.001) and percentage of body water content (P = 0.035). No relation was found, however, with waist/hip ratio, age, comorbidities, or medications. Conclusions These findings all suggest a relationship between hydration status and body composition but also set the bases for future studies that relate hydration status and anxiety status. These results can be used to improve the hydration status and body composition of military personnel.

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Availability of a Flavored Beverage and Impact on Children’s Hydration Status, Sleep, and Mood

Nutrients ◽

10.3390/nu13061757 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1757

Author(s):

Michael R. Szymanski ◽

Gabrielle E. W. Giersch ◽

Margaret C. Morrissey ◽

Courteney L. Benjamin ◽

Yasuki Sekiguchi ◽

...

Keyword(s):

Sleep Quality ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Intervention Group ◽

Urine Osmolality ◽

Urine Specific Gravity ◽

Hydration Status ◽

Control Group ◽

Profile Of Mood States ◽

Urine Color

Euhydration remains a challenge in children due to lack of access and unpalatability of water and to other reasons. The purpose of this study was to determine if the availability/access to a beverage (Creative Roots®) influences hydration in children and, therefore, sleep quality and mood. Using a crossover investigation, 46 participants were randomly assigned to a control group (CON) or an intervention group and received Creative Roots® (INT) for two-week periods. We recorded daily first morning and afternoon urine color (Ucol), thirst perception, and bodyweight of the two groups. Participants reported to the lab once per week and provided first morning urine samples to assess Ucol, urine specific gravity (USG), and urine osmolality (Uosmo). Participants also completed the questionnaires Profile of Mood States-Adolescents (POMS-a) and Pittsburgh Sleep Quality Index (PSQI). Dependent t-tests were used to assess the effects of the intervention on hydration, mood, and sleep quality. Uosmo was greater and Ucol was darker in the control group (mean ± SD) [Uosmo: INT = 828 ± 177 mOsm·kg−1, CON = 879 ± 184 mOsm·kg−1, (p = 0.037], [Ucol:INT = 5 ± 1, CON = 5 ± 1, p = 0.024]. USG, POMS-a, and PSQI were not significant between the groups. At-home daily afternoon Ucol was darker in the control group [INT = 3 ± 1, CON = 3 ± 1, p = 0.022]. Access to Creative Roots® provides a small, potentially meaningful hydration benefit in children. However, children still demonstrated consistent mild dehydration based on Uosmo, despite consuming the beverage.

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Rehydration with a Caffeinated Beverage during the Nonexercise Periods of 3 Consecutive Days of 2-a-Day Practices

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.14.4.419 ◽

2004 ◽

Vol 14 (4) ◽

pp. 419-429 ◽

Cited By ~ 22

Author(s):

Kelly A. Fiala ◽

Douglas J. Casa ◽

Melissa W. Roti

Keyword(s):

Body Fat ◽

Hydration Status ◽

Double Blind ◽

Psychological Measures ◽

Mild Heat ◽

Urine Color ◽

Significant Difference ◽

Before And After ◽

Time Point

The purpose of this study was to assess the influence of rehydration with a caffeinated beverage during non exercise periods on hydration status throughout consecutive practices in the heat. Ten (7 women, 3 men) partially heat-acclimated athletes (age 24 ± ly, body fat 19.2 ± 2%, weight 68.4 ± 4.0 kg, height 170 ± 3 cm) completed 3 successive days of 2-a-day practices (2 h/ practice, 4 h/d) in mild heat (WBGT = 23 °C). The 2 trials (double-blind, random, cross-over design) included; 1) caffeine (CAF) rehydrated with Coca-Cola® and 2) caffeine-free (CF) rehydrated with Caffeine-Free Coca-Cola®. Urine and psychological measures were determined before and after each 2-h practice. A significant difference was found for urine color for the post-AM time point, F = 5.526, P = 0.031. No differences were found among other variables (P > 0.05). In summary, there is little evidence to suggest that the use of beverages containing caffeine during non exercise might hinder hydration status.

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Half-Marathon and Full-Marathon Runners' Hydration Practices and Perceptions

Journal of Athletic Training ◽

10.4085/1062-6050-46.6.581 ◽

2011 ◽

Vol 46 (6) ◽

pp. 581-591 ◽

Cited By ~ 22

Author(s):

Eric K. O'Neal ◽

Jonathan E. Wingo ◽

Mark T. Richardson ◽

James D. Leeper ◽

Yasmine H. Neggers ◽

...

Keyword(s):

Total Sample ◽

Cross Sectional Study ◽

Hydration Status ◽

Little Rock ◽

Cross Sectional ◽

Marathon Runners ◽

Adverse Health Effects ◽

Urine Color ◽

Expected Performance ◽

Z Scores

Context: The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated. Objective: To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status. Design: Cross-sectional study. Setting: Marathon registration site. Patients or Other Participants: Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon. Intervention(s): A 23-item questionnaire was administered to runners when they picked up their race timing chips. Main Outcome Measure(s): Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented. Results: The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight. Conclusions: Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy.

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EXAMINING URINE COLOR AS A MEASURE OF HYDRATION STATUS DURING MOUNTAIN BIKE RACES IN THE HEAT

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-200105001-01443 ◽

2001 ◽

Vol 33 (5) ◽

pp. S256

Author(s):

D J. Casa ◽

L E. Armstrong ◽

E M. Berger ◽

W O. Dellis ◽

J C. Knight ◽

...

Keyword(s):

Hydration Status ◽

Mountain Bike ◽

Urine Color

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Effects of Three Oral Nutritional Supplements on Human Hydration Indices

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.2015-0244 ◽

2016 ◽

Vol 26 (4) ◽

pp. 356-362 ◽

Cited By ~ 3

Author(s):

Lindsay A. Ellis ◽

Brandon A. Yates ◽

Amy L. McKenzie ◽

Colleen X. Muñoz ◽

Douglas J. Casa ◽

...

Keyword(s):

Assessment Tool ◽

Urine Volume ◽

Urine Osmolality ◽

Ease Of Use ◽

Urine Specific Gravity ◽

Hydration Status ◽

Urine Color ◽

Significant Difference ◽

Oral Nutritional Supplements ◽

Double Blinded

Urine color (Ucol) as a hydration assessment tool provides practicality, ease of use, and correlates moderately to strongly with urine specific gravity (Usg) and urine osmolality (Uosm). Indicative of daily fluid turnover, along with solute and urochrome excretion in 24-hr samples, Ucol may also reflect dietary composition. Thus, the purpose of this investigation was to determine the efficacy of Ucol as a hydration status biomarker after nutritional supplementation with beetroot (880 mg), vitamin C (1000 mg), and riboflavin (200 mg). Twenty males (Mean ± SD; age, 21 ± 2 y; body mass, 82.12 ± 15.58 kg; height, 1.77 ± 0.06 m) consumed a standardized breakfast and collected all urine voids on one control day (CON) and 1 day after consuming a standardized breakfast and a randomized and double-blinded supplement (SUP) over 3 weeks. Participants replicated exercise and diet for one day before CON, and throughout CON and SUP. Ucol, Usg, Uosm, and urine volume were measured in all 24-hr samples, and Ucol and Usg were measured in all single samples. Ucol was a significant predictor of single sample Usg after all supplements (p < .05). Interestingly, 24-hr Ucol was not a significant predictor of 24-h Usg and Uosm after riboflavin supplementation (p = .20, p = .21). Further, there was a significant difference between CON and SUP 24-h Ucol only after riboflavin supplementation (p < .05). In conclusion, this investigation suggests that users of the UCC (urine color chart) should consider riboflavin supplementation when classifying hydration status and use a combination of urinary biomarkers (e.g., Usg and Ucol), both acutely and over 24 hr.

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Urine Color Analysis of Hydration Status in Employees Working in Bandung, Indonesia

Althea Medical Journal ◽

10.15850/amj.v7n4.1916 ◽

2020 ◽

Vol 7 (4) ◽

Author(s):

Liza Karina Hauteas ◽

Rudi Supriyadi ◽

Yenni Zuhairini

Keyword(s):

Water Intake ◽

Free Water ◽

Cross Sectional Study ◽

The Body ◽

Hydration Status ◽

Color Analysis ◽

Severe Dehydration ◽

Sunday Morning ◽

Cross Sectional ◽

Urine Color

Background: Dehydration can be compensated for by the body. However, if it occurs persistently, it can cause concentration problems, thermoregulation disorders, kidney damage, and other life-threatening disorders such as cardiovascular disorders. Urine color is a simple indicator to assess a person’s hydration status. The purpose of this study was to explore the hydration status of employees working in Bandung, Indonesia. Methods: This was a descriptive cross-sectional study conducted from March to November 2019. This study was a part of another study exploring urine color levels. Urine was collected on Sunday morning when the employees were free. Water intake and workload before urine examination were not taken into account. Hydration status was divided into three categories: well-hydrated, mild/moderate dehidration, and severe dehydration. A total sampling method was used to collect data. Results: In total, 178 subjects who met the study criteria participated in the study. The majority of respondents were 40-79 years old, male, did not have hypertension or diabetes, and active smokers. Most respondents experienced severe dehydration (44.7%) although 58.1% had consumed ≥8 glasses of water/day. Conclusion: More than half employees have consumed adequate amount of water; however, the majority are severely dehydrated when assessed based on their urine color. Further study on the balance of water intake and excretion is needed to explore the phenomenon of dehydration in the morning.

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Fluid Restriction Negatively Influences Perceived Morning Alertness and Visuomotor Ability

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010370 ◽

2021 ◽

Vol 19 (1) ◽

pp. 370

Author(s):

Courteney L. Benjamin ◽

Elliot P. Norton ◽

Benjamin M. Shirley ◽

Rebecca R. Rogers ◽

Tyler D. Williams ◽

...

Keyword(s):

Reaction Time ◽

Fluid Intake ◽

Urine Specific Gravity ◽

Hydration Status ◽

Fluid Restriction ◽

College Age ◽

Urine Color ◽

Before And After ◽

Two Fluid ◽

Over Time

The purpose of this study was to assess the effect of two fluid intake protocols on alertness and reaction time before and after fluid intake. Healthy college-age males (n = 12) followed two fluid intake protocols on separate occasions: (1) prescribed fluid (PF) and fluid restricted (FR). In PF, participants were instructed to consume 500 mL of fluid the night prior to and the morning of data collection. In FR, participants were instructed to refrain from the consumption of fluid for 12 h. To assess hydration status, urine specific gravity and urine color were measured. Participants perceived level of thirst and alertness were also recorded. Participants then completed visuomotor reaction time tests using the Dynavision LED board, using both a central visuomotor test and a peripheral visuomotor test (PVRT) prior to (1) and following (2) the ingestion of 100 mL of water. Participants displayed significantly improved PVRT in PF state as compared to FR (PF1 = 1.13 ± 0.16, PF2 = 1.04 ± 0.14; FR1 = 1.27 ± 0.27, FR2 = 1.18 ± 0.20; p = 0.038, ηp2 = 0.363). Both CVRT and PVRT improved over time, following the ingestion of 100 mL of fluid. Participants in the PF state were also significantly more alert than participants in the FR state (PF = 4 ± 2, FR = 5 ± 2; p = 0.019, ES = 0.839). Collectively, perceived alertness and PVRT were negatively impacted by FR.

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Hydration Status, Body Composition and Anxiety Status in Aeronautical Military Personnel from Spain: a cross-sectional study

10.21203/rs.3.rs-44178/v3 ◽

2020 ◽

Author(s):

Alejandra Carretero-Krug ◽

Carlos Velasco ◽

Juan Medina-Font ◽

Trinidad Trujillo Laguna ◽

Gregorio Varela-Moreiras ◽

...

Keyword(s):

Body Composition ◽

Water Balance ◽

Body Fat ◽

Water Intake ◽

Military Personnel ◽

Hydration Status ◽

Total Water ◽

Percentage Of Body Fat ◽

Urine Color ◽

Total Water Intake

Abstract Background: An adequate hydration status is critical to ensure efficiency during mental and physical activities. Our goal was to assess the hydration status of a Spanish group of aeronautical military men and to determine the association of hydration status with body composition and anxiety.Methods: 188 men were evaluated through a validated hydration questionnaire, anthropometric and biochemical parameters, and an anxiety questionnaire. According to that, criteria of hydration was established.Results: 81% of the total sample met hydration criteria (urine color = Well hydrated, Water Balance ≥ 0 mL, and total water intake/weight ≥35 mL/kg) and 19% did not meet hydration criteria (urine color = Not enough hydrated or Dehydrated, Water Balance < 0 mL, and total water intake/weight < 35 mL/kg). Subjects not meeting the hydration criteria had lower urine pH, negative water balance, and lower water intake. The latter also had higher anxiety status (score= 4 vs 3, p=0.026), weight (84.7 ± 10.5 vs 80.5 ± 10.2 Kg), Body Mass Index (26.3 ± 3.1 vs 25.2 ± 2.8 kg/m2), body fat (22.3 ± 5.6 vs 18.3 ± 6.5 %), urine specific gravity and urine color. The Hydration Status, in a logistic binary regression model was related significantly with the percentage of body fat (p=0.004), but no relation was found with age, comorbidity and medication. Furthermore, total water intake/weight was positively correlated with percentage of body water (rho=0.357, p=0.000) and negatively with body fat (kg) (rho= -0.427, p=0.000), percentage of body fat (rho= -0.405, p=0.000) and waist/hip ratio (rho= -0.223, p=0.002). The total water intake/weight, in a linear regression model was related significantly with the percentages of body fat (p=0.019) and body water (p= 0,035). No relation was found, however, with waist/hip ratio, age, comorbidity and medication.Conclusion: All these findings suggest a relationship between hydration status and body composition, but also set the bases for future studies that relate hydration status and anxiety status. These results can be used to improve the hydration status and body composition of military personnel.

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Accuracy of Urine Color to Detect Equal to or Greater Than 2% Body Mass Loss in Men

Journal of Athletic Training ◽

10.4085/1062-6050-51.1.03 ◽

2015 ◽

Vol 50 (12) ◽

pp. 1306-1309 ◽

Cited By ~ 17

Author(s):

Amy L. McKenzie ◽

Colleen X. Muñoz ◽

Lawrence E. Armstrong

Keyword(s):

Mass Loss ◽

Likelihood Ratio ◽

Body Mass ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Hydration Status ◽

Body Mass Loss ◽

Diagnostic Efficacy ◽

Hot Environment ◽

Urine Color

Context Clinicians and athletes can benefit from field-expedient measurement tools, such as urine color, to assess hydration state; however, the diagnostic efficacy of this tool has not been established. Objective To determine the diagnostic accuracy of urine color assessment to distinguish a hypohydrated state (≥2% body mass loss [BML]) from a euhydrated state (<2% BML) after exercise in a hot environment. Design Controlled laboratory study. Setting Environmental chamber in a laboratory. Patients or Other Participants Twenty-two healthy men (age = 22 ± 3 years, height = 180.4 ± 8.7 cm, mass = 77.9 ± 12.8 kg, body fat = 10.6% ± 4.6%). Intervention(s) Participants cycled at 68% ± 6% of their maximal heart rates in a hot environment (36°C ± 1°C) for 5 hours or until 5% BML was achieved. At the point of each 1% BML, we assessed urine color. Main Outcome Measure(s) Diagnostic efficacy of urine color was assessed using receiver operating characteristic curve analysis, sensitivity, specificity, and likelihood ratios. Results Urine color was useful as a diagnostic tool to identify hypohydration after exercise in the heat (area under the curve = 0.951, standard error = 0.022; P < .001). A urine color of 5 or greater identified BML ≥2% with 88.9% sensitivity and 84.8% specificity (positive likelihood ratio = 5.87, negative likelihood ratio = 0.13). Conclusions Under the conditions of acute dehydration due to exercise in a hot environment, urine color assessment can be a valid, practical, inexpensive tool for assessing hydration status. Researchers should examine the utility of urine color to identify a hypohydrated state under different BML conditions.

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