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Hydration: Replacing electrolytes with sports drinks and others

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 3 minutes read

Exercise uses up fluids and salts through sweating, breathing fast and hard, and making muscles work to their absolute max. There are so many products to take you beyond plain old water, the choice can be bewildering, so what’s going to fuel your gym session or get the most of your triathlon? Our pharmacist is here to cut through the big claims and let you know what’s behind the label.

Doctor’s advice

What’s the difference between rehydration drinks?

Every cell of your body needs electrolytes – salts such as sodium, potassium, magnesium, calcium and chloride – and these are kept in a delicate balance. Exercise can disrupt this, causing you to lose salts, and these need replacing. Water alone will just further dilute these salts, making your muscles feel more jaded and making you feel worse.

Sports drinks are designed to deliver glucose, which can work as fuel in intense bouts of exercise, plus salts and water. They work best with short, sharp bursts of intense exercise, such as football. This glucose is burned up by the muscles, and this conserves energy stores kept in fat and liver glycogen.

Oral electrolyte solutions have a higher concentration of salts, replenishing stores and helping you to retain more water than a normal sports drink would. If you’re trying to lose weight, the added bonus is that they contain much less sugar than sports drinks.

Energy drinks give you a mental boost. They’re a source of sugar and water plus stimulants like caffeine, which produce adrenaline to increase mental performance. This is great if you have an urgent deadline or some late-night studying, but it’s not going to improve your tennis game or the last miles of the marathon. it may even work against you in sports, as caffeine causes diuresis, making you pee water out and risking dehydration.

Which sports drink is right for me?

So you’ve decided on a sports drink. There are three main types, let’s talk through the science to work out which is right for you.

Isotonic drinks are the most popular as they’re a good all-rounder. They have a combination of salts and sugar that matches the concentration in your body. They work best in prolonged or intense workouts, such as team sports or marathons, where you need an energy boost alongside topping up salt losses.

But isotonic drinks can cause a bit of bloating and tummy discomfort if taken in large quantities during a workout, as they’re not absorbed as easily as electrolyte-only drinks.

Hypotonic solutions are best for straight-forward hydration, where you don’t need to replenish glucose. These have a lower concentration of salts and sugar than the body, and therefore suit sports such as gymnastics, sweating in hot climates or diarrhoea bugs. Most oral rehydration solutions or salts would fall under this.

Hypertonic solutions have a high concentration of salts and sugar, therefore give a calorie kick to those recovering after high-intensity sports, and help replenish glycogen stores of energy, ready for the next session.

These drinks aren’t for me, any other options?

A randomised controlled trial in 2016 assessed the potential of other drinks in the diet on hydration. The study found that fluids such as orange juice or coconut water were just as good at hydrating subjects compared to sports drinks. Milk was also very good at hydrating and quite similar to oral rehydration salts.

So when should I stick with water and when should I upgrade?

Water should be your first port of call. Your body is well able to adapt to fluctuations in salts and glucose, changing the amount you pee or breathe out, how much is absorbed in the gut, and altering sodium and potassium from inside cells to outside. It keeps you in balance all day every day.

So you only need to consider specialist hydration products if you’re putting exceptional requirements on your body, like high intensity or prolonged exercise. For those working out for 45 minutes or less, or doing only mild to moderate intensity, water should do the job. Oral hydration salts might help in recovery afterwards.

  • Written by Adil Naeem, Head of Healthwords Platform and a practising pharmacist

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023