Sensory Perception of an Oral Rehydration Solution during Exercise in the Heat

Prolonged exercise in the heat elicits a number of physiological changes as glycogen stores are low and water and electrolytes are lost through sweat. However, it is unclear whether these changes provoke an increase in liking of saltiness and, therefore, palatability of an oral rehydration solution (ORS). Twenty-seven recreationally active participants (n = 13 males; n = 14 females) completed sensory analysis of an ORS, a traditional sports drink (TS), and a flavored water placebo (PL) at rest and during 60 min (3 × 20-min bouts) of cycling exercise at 70% age-predicted maximum heart rate (HRmax) at 35.3 ± 1.4 °C and 41 ± 6% relative humidity. Before and after every 20 min of exercise, drinks were rated (using 20-mL beverage samples) based on liking of sweetness, liking of saltiness, thirst-quenching ability, and overall liking on a nine-point hedonic scale. Hydration status was assessed by changes in semi-nude body mass, saliva osmolality (SOsm), and saliva total protein concentration (SPC). After 60 min of exercise, participants lost 1.36 ± 0.39% (mean ± SD) of body mass and there were increases in SOsm and SPC. At all time points, liking of sweetness, saltiness, thirst-quenching ability, and overall liking was higher for the TS and PL compared to the ORS (p < 0.05). However, the saltiness liking and thirst-quenching ability of the ORS increased after 60 min of exercise compared to before exercise (p < 0.05). There was also a change in predictors of overall liking with pre-exercise ratings mostly determined by liking of sweetness, saltiness, and thirst-quenching ability (p < 0.001), whereas only liking of saltiness predicted overall liking post-exercise (R2 = 0.751; p < 0.001). There appears to be a hedonic shift during exercise in which the perception of saltiness becomes the most important predictor of overall liking. This finding supports the potential use of an ORS as a valuable means of hydration during the latter stages of prolonged and/or intense exercise in the heat.

Comment on Fan et al. Efficacy of Ingesting an Oral Rehydration Solution after Exercise on Fluid Balance and Endurance Performance. Nutrients 2020, 12, 3826

Our lab read with interest the recent article published in Nutrients comparing different drink composition on fluid balance [...]

Reply to Dumke, C. Comment on “Fan et al. Efficacy of Ingesting an Oral Rehydration Solution after Exercise on Fluid Balance and Endurance Performance. Nutrients 2020, 12, 3826”

We would like to thank Dr. Charles Dumke for taking interest in our recent publication [...]

To Determine Outcome of Probiotics in Treatment of Acute Diarrhea in Children

Aim: To determine outcome of probiotics in treatment of acute diarrhea in children aged 6 months to 5 years as compared to control Setting: Department of Pediatrics, Khyber Teaching Hospital, Peshawar Duration: From 23 May, 2019 to 23 Nov, 2019 Study design: Randomized Control Trial Methodology: 200 children were divided in two equal groups. Group A were given Probiotics (Saccharomyces boulardii) in a dose of 250-500 mg daily in two divided doses for 5 days, in addition to oral rehydration solution 50-100ml and 100-200ml after each loose stool in child aged <2 years and >5 years respectively. Group B were given only oral rehydration solution in same amount as prescribed to Group A. All the children were followed up at day 4. Outcome was assessed in terms of duration of diarrhea and improvement in number of stools per day at the 5th day of presentation. Results: In Group A, 92(92%) patients showed improvement while in Group B, 71(71%) patients showed improvement. Conclusion: Probiotics are found to be significantly more effective in reducing the stool frequency in ac. diarrhea. Keywords: Acute diarrhea, Probiotic, Saccharomyces boulardii (SB)

COMPARISON OF LOW OSMOLAR ORAL REHYDRATION SOLUTION VERSUS STANDARD ORAL REHYDRATION SOLUTION IN CHILDREN WITH ACUTE DIARRHOEA IN RELATION TO UNSCHEDULED INTRAVENOUS FLUID REQUIREMENT

Objective: To determine requirement of unscheduled I/V fluid in children treated with low osmolar oral rehydration solution as compare to standard oral rehydration solution. Study Design: Case control study. Place and Duration of Study: Department of Paediatrics, Lahore General Hospital, Lahore, from Sep 2018 to Feb 2019. Methodology: Sample size of 400 patients was calculated using WHO calculator. Patients were recruited through non probability consecutive sampling. Patients were randomly divided into two groups. For each patient detailed history was taken including demographic information. Group A patients (controls) receive standard oral rehydration solution and Group B patients will receive low osmolar oral rehydration solution (Cases). Each group was followed for 6 hours after the treatment. Data analysis was done using SPSS version 24. Chi-square test applied and p-value ≤0.05 found significant. Results: A total of 400 cases were enrolled in the study. There were 220 (55%) male and 180 (45%) female in our study. Mean weight of patients was 9.46 Kg ± 5.9 SD. In group A, 8 patients showed unscheduled fluid requirement while 192 did not showed unscheduled fluid requirement. In group B, 32 patients showed unscheduled fluid requirement while 168 did not showed unscheduled fluid requirement (p=0.000). Conclusions: Incidence of or need of, unscheduled I/V fluid in children treated with low osmolar oral rehydration solution is less as compare to standard oral rehydration solution for management of acute diarrhea with some dehydration. And hence low osmolar oral rehydration solution shows better acceptance in management of acute diarrhea.

Effect of oral rehydration solution versus spring water intake during exercise in the heat on muscle cramp susceptibility of young men

Background Muscle cramp is a painful, involuntary muscle contraction, and that occurs during or following exercise is referred to as exercise-associated muscle cramp (EAMC). The causes of EAMC are likely to be multifactorial, but dehydration and electrolytes deficits are considered to be factors. This study tested the hypothesis that post-exercise muscle cramp susceptibility would be increased with spring water ingestion, but reduced with oral rehydration solution (ORS) ingestion during exercise. Methods Ten men performed downhill running (DHR) in the heat (35–36 °C) for 40–60 min to reduce 1.5–2% of their body mass in two conditions (spring water vs ORS) in a cross-over design. The body mass was measured at 20 min and every 10 min thereafter during DHR, and 30 min post-DHR. The participants ingested either spring water or ORS for the body mass loss in each period. The two conditions were counter-balanced among the participants and separated by a week. Calf muscle cramp susceptibility was assessed by a threshold frequency (TF) of an electrical train stimulation to induce cramp before, immediately after, 30 and 65 min post-DHR. Blood samples were taken before, immediately after and 65 min after DHR to measure serum sodium, potassium, magnesium and chroride concentrations, hematocrit (Hct), hemoglobin (Hb), and serum osmolarity. Changes in these varaibles over time were compared between conditions by two-way repeated measures of analysis of variance. Results The average (±SD) baseline TF (25.6 ± 0.7 Hz) was the same between conditions. TF decreased 3.8 ± 2.7 to 4.5 ± 1.7 Hz from the baseline value immediately to 65 min post-DHR for the spring water condition, but increased 6.5 ± 4.9 to 13.6 ± 6.0 Hz in the same time period for the ORS condition (P < 0.05). Hct and Hb did not change significantly (P > 0.05) for both conditions, but osmolarity decreased (P < 0.05) only for the spring water condition. Serum sodium and chloride concentrations decreased (< 2%) at immediately post-DHR for the spring water condition only (P < 0.05). Conclusions These results suggest that ORS intake during exercise decreased muscle cramp susceptibility. It was concluded that ingesting ORS appeared to be effective for preventing EAMC.

Are oral rehydration solutions optimized for treating diarrhea?

Background: A historical turning point occurred in the treatment of diarrhea when it was discovered that glucose could enhance intestinal sodium and water absorption. Adding glucose to salt water (oral rehydration solution, ORS) more efficiently replaced intestinal water and salt losses. Aim: Provide a novel hypothesis to explain why mainstream use of ORS has been strongly recommended, but weakly adopted. Methods: Traditional (absorptive) and novel (secretory) physiological functions of glucose in an ORS were reviewed. Results: Small amounts of glucose can stimulate both intestinal absorption and secretion. Glucose can exacerbate a net secretory state and may aggravate pathogen-induced diarrhea, particularly for pathogens that affect glucose transport. Conclusion: A hypothesis is made to explain why glucose-based ORS does not appreciably reduce diarrheal stool volume and why modern food science initiatives should focus on ORS formulations that replace water and electrolytes while also reducing stool volume and duration of diarrhea.

Knowledge and Practice of Oral Rehydration Solution in Diarrhoea of the Mothers Attending ORT Corner of Rajshahi Medical College Hospital

This cross sectional type of descriptive study was carried out among the mothers, who attended ORT corner of Rajshahi Medical College Hospital for the treatment of diarrhoea of their children to assess their knowledge and practice of oral rehydration solution in diarrhoea. The sample size was 385, which was selected purposively. Data were collected from the respondents by face to face interview according to a partially structured questionnaire. Data were analysed by using SPSS software programme and interpretations were done using appropriate statistical tests like Chi Square Test. Ethical issues were considered throughout the study. Majority (62.5%) of the mothers were in the age group of 21 – 30 years and most (71%) of them were housewives. Most (95.12%) of the mothers knew the preparation of ORS correctly but only 42.82% of them used ORS properly during diarrhoea of their children. The relationship of correct knowledge on ORS preparation was direct with literacy level and monthly family income of the mothers, which were significant (p<0.05). Knowledge on ORS preparation was found significantly more among house wives in comparison to other professions (p<0.05) but there was no significant relationship between knowledge on ORS preparation and age group of the mothers (p>0.05). Correctly use of ORS during diarrhoea of the children was found significantly associated with family income (p<0.05) but was not found associated with age and literacy level of the mothers (p>0.05 each). This study provided some important information regarding knowledge and practice on ORS use of the mothers in Rajshahi region. TAJ 2020; 33(2): 32-38

Efficacy of Ingesting an Oral Rehydration Solution after Exercise on Fluid Balance and Endurance Performance

This study investigated the efficacy of ingesting an oral rehydration solution (DD) that has a high electrolyte concentration after exercise on fluid balance and cycling performance in comparison with a sports drink (SD) and water (WA). Nine healthy males aged 24 ± 2 years (mean ± SD), with peak oxygen uptake (VO2 peak) 55 ± 6 mL·kg−1·min−1 completed three experimental trials in a randomised manner ingesting WA, SD (carbohydrates: 62 g·L−1, sodium: 31 ± 3 mmol·L−1) or DD (carbohydrates: 33 g·L−1, sodium: 60 ± 3 mmol·L−1). On all trials, fluid was ingested during 75 min cycling at 65% VO2 peak (temperature: 30.4 ± 0.3 °C, relative humidity: 76 ± 1%, simulated wind speed: 8.0 ± 0.6 m·s−1) and during 2 h of recovery (temperature: 23.0 ± 1.0 °C, relative humidity: 67 ± 2%), with the total volume equivalent to 150% of sweat loss during the ride. A 45 min pre-load cycling time trial at a 65% VO2 peak followed by a 20 km time trial was conducted after a further 3 h of recovery. Fluid retention was higher with DD (30 ± 15%) than WA (−4 ± 19%; p < 0.001) and SD (10 ± 15%; p = 0.002). Mean ratings of palatability were similar among drinks (WA: 4.25 ± 2.60; SD: 5.61 ± 1.79; DD: 5.40 ± 1.58; p = 0.33). Although time trial performance was similar across all three trials (WA: 2365 ± 321 s; SD: 2252 ± 174 s; DD: 2268 ± 184 s; p = 0.65), the completion time was faster in eight participants with SD and seven participants with DD than with WA. Comparing SD with DD, completion time was reduced in five participants and increased in four participants. DD was more effective at restoring the fluid deficit during recovery from exercise than SD and WA without compromising the drink’s palatability with increased sodium concentration. Most individuals demonstrated better endurance exercise time trial performance with DD and SD than with WA.