Introduction

Collegiate athletes in the United States of America generally recognize the importance of proper hydration during physical activity (Nichols et al., 2005; Volpe et al., 2009). However, some individuals lack the knowledge and resources needed to adequately rehydrate and refuel during physical activity, which could then lead to detriments in performance. In fact, 66% of National Collegiate Athletic Association (NCAA)

Division I athletes at a single university were found to be in a state of hypohydration pre-practice (Volpe et al., 2009). Hypohydration stresses the cardiovascular system and reduces physical capacity, placing an athlete at a higher risk for musculoskeletal injury (Berning and Steen, 1991). In order to implement a successful hydration protocol, it is important that athletes, coaches, athletic trainers, and strength and conditioning professionals understand the importance of maintaining proper hydration and nutrition, as well as the critical components of hydration education (Casa et al., 2000).

The risks of dehydration and potential consequences to performance can be unique to track and field athletes, as their fluid needs are highly variable as a result of the diverse nature of events, training programs, and individual differences among athletes (Casa et al., 2019). Sweating rates among track and field athletes can range from 0.5 to 3.0 L/hr (Baker et al., 2016) due to differences in factors such as body size, exercise intensity, exercise duration, environment, and choice of clothing (Casa et al., 2019). Although the influence of dehydration on performance has been extensively studied in endurance exercise, how it impairs performance in sports that require repeated bouts of short-term high intensity efforts is not as well studied (Maughan and Shirreffs, 2010). A review of the effects of dehydration on muscle strength, power, and high-intensity anaerobic capacity demonstrated that dehydration could have an impact on strength and power. Cheuvront and Kenefick (2014) reported that ≥ 2% dehydration impaired endurance exercise performance mediated by body water volume loss. According to Judelson et al. (2007) hypohydration appears to consistently attenuate strength (by approximately 2%), power (by approximately 3%) and high-intensity endurance (by approximately 10%). According to a meta-analysis by Savoie et al. (2015), hypohydration caused muscle strength to fall by 5.5 ± 1.0% (p < 0.05) and anaerobic power fell (-5.8 ± 2.3%). This suggests alterations in total body water can affect some aspects of force generation. According to research examining differences between euhydrated and dehydrated conditions, there is a direct connection between body water deficits (2.9% of body mass) and an athlete’s ability to generate upper and lower body anaerobic power (Jones et al., 2008). Therefore, it is important for track and field athletes competing in events such as jumping, throwing, sprints, and multi-events to begin training and competition in a state of optimal hydration and consume sufficient fluid during exercise to optimize performance and health (Casa et al., 2019).

Despite awareness of the status of dehydration and the negative effect it may have on performance, athletes often fail to practice appropriate hydration strategies. For example, previous research has shown that athletes generally lack knowledge of the appropriate markers for self-regulating adequate hydration levels (O'Neal et al., 2011; Yeargin et al., 2010). This may include a lack of clarity about appropriate targets for fluid intake, beverage types, and important information to monitor. Athletes are often unaware of the best methodologies for determining hydration status such as urine specific gravity, urine color, changes in body mass, plasma osmolality and bioimpedance. The National Athletic Trainers' Association (NATA) recommends the following practices regarding fluid replacement for athletic participation: athletes should begin a training session well hydrated by drinking approximately 500 to 600 ml of water or sports drink 2 to 3 hours before exercise and additional 200 to 300 ml of water or a sports drink 10 to 20 min before exercise. During the training session fluid replacement should approximate sweat and urine losses and maintain hydration at a level that keeps body weight loss to <2%. This can generally be achieved by the consumption of 200 to 300 ml of fluid every 10 to 20 min. Post-activity hydration should aim to correct any fluid loss accumulated during the practice or competition. Water quality and alkalinity are also factors to consider for fluid replacement as alkaline mineral water has been shown to potentially offer advantages in hydration post-exercise (Chycki et al., 2017). Additionally, research has shown that mineral content for tap and bottled water varies by region (Azoulay et al., 2001), therefore it may be important for coaches and athletes to be aware of the quality and composition of locally available water sources.

Specific recommendations for individual athletes depend on body mass, sweat rate, environment and tolerance (Casa et al., 2000). In addition to limited knowledge, athletes face many unique barriers that prevent the specific application of that knowledge. This may be especially true for the throwing events in track and field (Judge et al., 2013) which are often segregated from the other events due to safety concerns (Judge et al., 2010). Thus, while hydration in endurance events have been extensively investigated, the effects of hydration in other areas of track and field, especially throwing, have yet to be clearly defined. Therefore, the purpose of this study was to identify knowledge, attitudes, and behaviors among a sample of NCAA collegiate track and field throwers (CTFTs) related to current science regarding hydration (Nichols et al., 2005).

Methods

Results

Participant demographics are included in Table 1. The findings were separated into three thematic categories: knowledge, attitudes, and behaviors. Knowledge was operationally defined as a set of understandings or beliefs on the topic grounded in science. Attitudes were defined as “leaning to” or “tendencies to” as attitudes frequently serve as a bridge between knowledge and practices, yet numerous studies show that a weak relationship exists between knowledge and practices. Pearson correlation analysis revealed several significant positive correlations between knowledge, attitude, and behavior scores of participants (Table 2).

Discussion

Research has shown that although athletes understand the importance of rehydration, they may lack the knowledge needed to maintain hydration (Carvalho et al., 2011; Casa et al., 2000; Jonnalagadda et al., 2001). This may impact performance and set the stage for potential adverse medical conditions during vigorous physical activity. Enhanced knowledge can improve attitudes and behaviors, as indicated by the significant and positive correlations identified in this study and previous research (Nichols et al., 2005). The results of the current study indicate that CTFTs are fairly knowledgeable on the topic of hydration, which makes them more likely to consume fluid before dehydration occurs (Table 2). However, some view thirst as the single indicator of hydration status which may not be true in all instances. Previous research has indicated that thirst-guided hydrating leads to dehydration when performing long duration exercise in a hot and humid environment (Wilk and Bar-Or, 1996). While there is some debate about the best manner to acutely determine hydration, it is often recommended that a combination of measures such as body mass and urine osmolality be used (Casa et al., 2000). Since our study did not identify significant correlations between CTFTs who intended to eat a nutritious diet and hydration behaviors, other than consuming 503 – 591 ml of fluid 2-3 hours prior to activity, there may not be a relationship between those who intended to practice healthy behaviors with their actions.

The appropriate use of sports drinks is not well understood by CTFTs (Nichols et al., 2005; Sawka et al., 2007). The physical demands of CTFTs involve repeated bouts of high-intensity exercise over the course of several hours, suggesting they should be mindful of effective refueling strategies. There is evidence to suggest that the ingestion of a carbohydrate beverage consumed at regular intervals delays fatigue in athletes who participate in intermittent, high-intensity exercise (Davis et al., 1997). A recent study also found significantly less weight loss (i.e. water loss) in athletes who consumed a sports drink versus those who consumed water (Carvalho et al., 2011). In addition, only 67.5% (n = 199) of CTFTs in this study reported that a sports drink should be consumed within two hours after exercise. The evidence suggests that rehydrating and refueling post-exercise should occur within two hours and should consist of foods and drinks that contain sodium which will stimulate thirst and assist in the retention of fluids (Casa et al., 2000; Sawka et al., 2007). Sports drinks are readily available and typically contain sodium to meet this need. Since carbohydrate stores are likely low or depleted post-exercise, a sports drink will also serve to provide an adequate supply of carbohydrates and electrolytes that will not hinder rehydration (Casa et al., 2000). One and four tenths of a percent (1.4%, n = 122) of participants reported that consuming a sports drink would aid in restoring muscle glycogen. During exercise, the goal of consuming a sports drink is to maintain blood glucose levels (Casa et al., 2000). However, post-exercise, the consumption of sports drinks may assist in muscle glycogen restoration. Ultimately, when an athlete needs to quickly rehydrate and/or refuel after exercise, as when preparing for another exercise bout, then the use of sports drinks will assist with carbohydrate restoration without compromising gastric emptying (Casa et al., 2000). However, if the exercise session has concluded, rapid fluid replacement may not be as critical, thus ingesting a higher concentration of carbohydrates will be more effective in restoring muscle glycogen (Casa et al., 2000). Our findings indicate that confusion exists regarding the most appropriate use of sports drinks, thus education of athletes in this area is needed.

Fortunately, the CTFTs’ attitudes on hydration were positive, as the majority of participants believed that hypohydratoin and dehydration would decrease athletic performance. This is important because hypohydration has been shown to have a negative impact on performance among athletes in certain instances such as in the heat (Casa et al., 2000). However, there were slight contrasts in the CTFTs’ attitudes on hydration and their actual behaviors, which is consistent with previous findings in a study conducted on collegiate freshman football players (Jonnalagadda et al., 2001). A high percentage (81.3%) of participants believed that consuming 503 – 591 ml of fluid a few hours before competition was important, while 78.5% reported that they actually consumed that amount. On the other hand, 59.7% believed that consuming 207 – 295 ml of fluid 10-20 min before competition was important, and 62.2% reported actually consuming that amount. A recent study found a correlation between fluid intake and knowledge scores and fluid intake and behavior scores in high performing adolescent basketball players (Carvalho et al., 2011). The findings in our study indicate that athletes should be more knowledgeable on appropriate ways to practice proper hydration and fueling practices, particularly as it relates to pre-exercise hydration, the indicative value of thirst and the appropriate use of sports drinks. Furthermore, they should be continually encouraged by SCs and athletic trainers to ensure that they consume appropriate amounts of fluids if the exercise type or the environment necessitates more than drinking due to thirst. This is particularly crucial when athletes exercise in the heat, as dehydration will lead to increased core body temperature under this environmental condition making them susceptible to exertional heat illness (Casa et al., 2000). Knowledge alone is not enough; proper information on application of such knowledge is important as well.

A lack of access to fluids throughout practice or competition can create additional barriers to proper hydration for athletes. The results of the study indicated that facility location or practice times influenced the accessibility of water. These barriers are a result of CTFTs being segregated from the other competitors due to concern that unsuspecting athletes or officials may be struck by flying shots, hammers, discuses and javelins (Judge et al., 2010). This safety-based competitive segregation issue within track and field may be extenuated by the many hours most throwers, who typically possess the largest BMI indexes on track and field teams, spend outdoors during meets. Among runners, this barrier may be most evident when out on a run and away from resources that may provide an opportunity to rehydrate (Judge et al., 2010). Also, water is typically the most widely available option for athletes during competition. Despite the convenience and availability of drinking water, athletes may be less likely to consume water unless it is flavored and has greater taste appeal (Bar-Or and Wilk, 1996). However, in the present study, the majority of athletes disagreed with the statement that sports drinks were better than water. All of these factors can present challenges for rehydrating and refueling during training or competition.

The majority of CTFTs indicated that their sources of nutrition information were their coaches and the Internet. Thus, a team approach should be implemented between coaches and strength and conditioning professionals to educate and encourage proper hydration practices. Both field event coaches and SCs can implement ways for their athletes to practice proper hydration behaviors, including the use of a urine color chart, which is one of the easiest ways for athletes to self-assess their hydration status (Volpe et al., 2009).

Results of this study indicate that CTFTs are generally knowledgeable about proper refueling and hydration, but do not always put that knowledge into practice. Confusion exists on the proper utilization of carbohydrate-electrolyte beverages (i.e. sports drinks) for rehydrating and refueling, thus education in this area is warranted. Education on the behalf of SCs could clear the confusion with regard to the optimal beverage for rehydrating based on the needs of the athlete. Close monitoring by SCs, such as weigh-ins before and after practices and competitions, could also enhance hydration practices so that athletes can see how much fluid was lost through sweat during activity. Since coaches are a primary source for nutritional information, it is critical that coaches convey the most accurate and up-to-date information, and encourage athletes to practice appropriate hydration strategies. Therefore, SCs should work closely with the field event coaches to provide evidence-based resources in the area of hydration that would be of value to CTFTs. Since CTFTs may, at times, be segregated from the rest of the competitors at meets, which could lead to a lack of resources for them to stay hydrated, it is important for SCs to ensure that all participants, regardless of where they compete, have access to fluids in order to prevent dehydration.

It is important to acknowledge the limitations of the current study. There are some factors to consider that may have affected the results of the present study. On the perception scale, participants may have attempted to present themselves and their perceptions in a more positive light, and participants potentially may have worried about the perceived repercussions caused from their answers. While the current sample is adequate to present the findings of the study, a larger sample may have revealed additional findings of importance. This descriptive study did not include important qualitative aspects like dialogue with ATs about the hydration status of CRFTs, nor with CTFTs about their attitudes toward use of an isolated facility with limited access to hydration. Giving voice to the viewpoints expressed in the survey data could have added depth to the results. The discussion of the study, therefore, was limited to issues potentially surrounding the quantitative descriptive data collected. Future studies related to this research should extend to other populations of athletes in order to gather results more generalizable to all sports.