By Linda Carroll
Dehydration can impair a person's ability to think clearly, a new study suggests.
Researchers found that athletes who lost fluid equal to 2 percent their weight took a hit to their cognition. Even this mild to moderate level of dehydration- the loss of 2 pounds for someone who weighs 100 pounds and 4 pounds for someone weighing 200 - led to attention problems and impaired decision making, according to the report in the journal Medicine & Science in Sports & Exercise, online June 21.
In particular, dehydration led to impairment in tasks requiring attention, motor coordination, and executive function, which includes things like map recognition, grammatical reasoning, mental math, and proofreading, for example.
"We've known that physical performance suffers at a threshold of 2 percent of body mass, particularly when it's from exercise in a warm environment," said study coauthor Mindy Millard-Stafford, a professor in the school of biological sciences and director of the physiology lab at the Georgia Institute of Technology.
"So the question was, what happens in the brain with the same amount of loss, which is pretty common with people who are active or work outside in the heat. Just like a muscle cell needs water, so do the cells in our brain."
While the effects weren't huge at 2 percent, they increased with increasing dehydration, Millard-Stafford said.
The new study isn't the first to look at the impact of dehydration on cognition. But earlier research yielded mixed findings, possibly because studies were based on small numbers of subjects. Millard-Stafford decided to get around that pitfall by performing a meta-analysis of relevant research.
After scouring the medical literature, the researchers found 33 studies involving a total of 413 adults. Participants lost fluids amounting to 1 to 6 percent of their body mass either through exercise alone, exercise coupled with heat, heat alone or fluid restriction.
The study may be particularly timely as much of the country suffers through a heat wave. And it may remind weekend warriors as well as more dedicated athletes of the importance of staying hydrated.
"I think this reinforces something we thought was true," said Dr. Ronald Roth, a professor of emergency medicine at the University of Pittsburgh School of Medicine, medical director of the Dick's Sporting Goods-Pittsburgh Marathon and one of the team physicians for the Pittsburgh Steelers. "The big picture here is that the more dehydrated you are the less sharp you are. And your decision-making abilities get lost sooner than later."
Before this new research came along, a person might have happened upon one of the earlier studies that found no cognitive effects from dehydration and thought that dehydration wouldn't harm their thinking, Roth said.
"As a meta-analysis, this study is bigger and more helpful than the earlier individual studies," said Roth, who is unaffiliated with the new research. "With a bigger pool of patients, you can get more robust information."
It can be hard to diagnose dehydration, so it's important for individual athletes to keep track of how much fluid they're taking in and how much they've lost, Roth said. Still, certain symptoms should be reminders that it's time to take in more fluid: fatigue, muscle weakness, decreased urine output, confusion.
The Pittsburgh doctor also recommends that on especially hot days, athletes make a plan before working out so potentially clouded judgment won't steer them wrong.
Roth warns against overdoing things and taking in too much water, which can lead to a dangerous condition known as hyponatremia. That condition occurs when there's too much water compared to the amount of salt in the body.
"It's important to know the right water balance," Millard-Stafford concurred. "You need to know that you can have not just too little but also too much."
The color of your urine is a simple way of monitoring your fluid levels, Millard-Stafford said. "If it's very, very clear, then you are probably drinking far more than necessary," she explained. "But if it's dark gold that may mean the kidneys need a little more reserve since they're concentrating your urine to keep the balance where it needs to be."
Med Sci Sports Exerc 2018.
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