A systematic review about rehydration drinks for exertion-related dehydration


Dehydration associated with exertion is a commonly encountered condition in the first aid setting, particularly at sporting events. The First Aid Task Force of the International Liaison Committee on Resuscitation (ILCOR), in which CEBaP takes part, identified rehydration after exertion-related dehydration as a priority topic. As part of the development of new evidence-based treatment recommendations, we conducted a systematic review, comparing water with different types of drinks that could be used for rehydration after prolonged exercise. The systematic review was published in two parts, with the first part reviewing the effectiveness of carbohydrate-electrolyte (CE) solutions, commonly referred to as sports drinks. In the second part, we reviewed alternative beverages such as milk, coconut water and beer.

Out of 3485 studies, we finally included 20 studies that assessed CE solutions (0% - 9% carbohydrate) and 11 studies comparing skim or low-fat milk, coconut water, and beer (0-5% alcohol) with water. We found a potential beneficial effect from ingesting CE drinks when compared with water, for many of the reviewed outcomes. In addition, consuming skim or low-fat cow’s milk without additional food appeared to improve volume/hydration status, as compared with water. No significant differences were found with coconut water (compared with water), and there was insufficient evidence to recommend beer for rehydration (0-5% alcohol).
Based on this (limited) evidence, the use of commercial CE drinks (4-9% ideally, or else 0-3.9%) consuming skim or low-fat cow’s milk could be suggested for rehydration in people suffering from exertion-related dehydration. However, if clean drinkable water is available, its cost, relative to CE drinks, make it an acceptable alternative.

Both parts of the review are published in Journal of Athletic Training. The review on CE drinks can be found here, the one on alternative drinks here. In addition, our work was selected as article of the month on the online platform Release by Felis, a platform aimed at athletes, coaches, sports directors, and all those who wish to develop their professional skills in the field of sport.