Nutr Hosp. 2015;31(5):1889-1899 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318 Revisión Hydration and chemical ingredients in sport drinks: food safety in the European context Aritz Urdampilleta1,2, Saioa Gómez-Zorita3, José M. Soriano4, José M. Martínez-Sanz5, Sonia Medina6 and Angel Gil-Izquierdo6 1Department of Sport and Physical Education.Faculty of Psychology and Education. University of Deusto. 2Scientific and Technical Advisor in ElikaEsport. 3Faculty of Pharmacy. University of the Basque Country (UPV/EHU). 4Observatory for Nutrition and Food Safety for the Developing World, Faculty of Pharmacy. University of Valencia. 5Department of Nursing, Faculty of Health Sciences and ALINUA- Cabinet of food and nutrition. University of Alicante. 6Department of Food Science and Technology. CEBAS-CSIC. Campus de Espinardo-25, Murcia. Spain. Abstract HIDRATACIÓN E INGREDIENTES QUÍMICOS EN EL DEPORTE: SEGURIDAD ALIMENTARIA Before, during and after physical activity, hydration is EN EL CONTEXTO EUROPEO a limiting factor in athletic performance. Therefore, ade- quate hydration provides benefits for health and perfor- mance of athletes. Besides, hydration is associated to the Resumen intake of carbohydrates, protein, sodium, caffeine and Antes, durante y después de la actividad física, la other substances by different dietary aids, during the tra- hidratación es un factor limitante en el rendimiento ining and/or competition by athletes. These requirements deportivo. Por lo tanto, una adecuada hidratación pro- have led to the development of different products by the porciona beneficios para la salud y el rendimiento de los food industry, to cover the nutritional needs of athletes. deportista. Además, la hidratación se asocia a la ingesta Currently in the European context, the legal framework de hidratos de carbono, proteínas, sodio, cafeína y otras for the development of products, substances and health sustancias durante el entrenamiento y/o competición de claims concerning to sport products is incomplete and los deportistas. Estos requisitos han llevado al desarro- scarce. Under these conditions, there are many products llo de diferentes productos por parte de la industria ali- with different ingredients out of European Food Safety mentaria, para cubrir las necesidades nutricionales de Authority (EFSA) control where claims are wrong due los deportistas. Actualmente en el contexto europeo, el to no robust scientific evidence and it can be dangerous marco legal para el desarrollo de productos, sustancias y for the health. Further scientific evidence should be cons- declaraciones nutricionales y de propiedades saludables tructed by new clinical trials in order to assist to the Ex- relativas a productos deportivos, es incompleta y escasa. perts Commitees at EFSA for obtaining robust scientific Hay muchos productos con diferentes ingredientes con- opinions concerning to the functional foods and the indi- trolados por la Agencia Europea de Seguridad Alimenta- vidual ingredients for sport population. ria (EFSA), los cuales poseen declaraciones nutricionales (Nutr Hosp. 2015;31:1889-1899) y de propiedades saludables erróneas, debido a la falta o escasa evidencia científica, resultado peligroso para la DOI:10.3305/nh.2015.31.5.7867 salud. Se necesita mayor evidencia científica obtendia a Key words: Sports. Hydration. Drinks. Food safety. In- través de nuevos ensayos clínicos con el fin de ayudar a gredients. Natural foods. Functional. los Comités de expertos de la EFSA para la obtención de dictámenes científicos sólidos relativos a los alimentos funcionales y los ingredientes individuales para la pobla- ción deportiva. (Nutr Hosp. 2015;31:1889-1899) DOI:10.3305/nh.2015.31.5.7867 Palabras clave: Deportes. Hidratación. Bebidas. Segu- ridad alimentaria. Ingredientes. Comida natural. Bebidas funcionales. Correspondence: Aritz Urdampilleta. Departmental Area: Science of Physical Activity and Sport. Faculty of Psychology and Education. University of Deusto. Campus of Donostia - San Sebastian. E-mail: [email protected] Recibido: 31-VII-2014. 1.ª Revisión: 4-XI-2014. Aceptado: 28-I-2015. 1889 001_7867 Hydration and chemical ingredients.indd 1889 15/04/15 07:33 Hydration products in the European Union Table I Characteristics of sports drinks taken during exercise. Bodily hydration during sporting activity is one of the best indicators of health in athletes1, and can be a Minimun Maximun limiting factor for sporting performance. Dehydration Sugars (%) 6 9 decreases the athletic performance and can suppose a risk to health when competitions are conducted under Mix of rapid absorption sugars (glucose or malto- 2 [Fructose] temperature stress . For example, in mountaineering Type of sugars dextrin) and sugars of slow >33% (at 0ºC), the body temperature can decrease to <35ºC, absorption rate (fructose) in leading to hypothermia or partial frostbite in the ex- the ratio 3/1. tremities (especially fingers and toes) due to the peri- Minerals (g/L) 0,46 1,20 pheral vasoconstriction. This effect is more common Na in poorly hydrated mountaineers3. Osmolarity (mOs- Moderate dehydration (2-3%) is the limit at which 200 330 begins the decrease of the physical and cognitive per- m/L) Volume (mL) formance in environments with mild temperatures. In 500 1000 this case, a decrease in plasmatic volume, an increase /hour of exercise in heart rate, and a decrease in blood flow to the skin Temperature (ºC) 10 15 reduce perspiration and heat dissipation – so that an Frequency (min) 1,2 15 30 increase in 1 °C body temperature is initiated . When in the exercise body temperature reaches 39°C, the physical perfor- mance drops dramatically due to a malfunction of the - In extreme temperatures (>30ºC), add biological system for energy production and alterations ice cubes to the drink. - Palatable drink. 19 Particular charac- can also be observed at a neurophysiological level . At - In case of high hydration needs, it is teristics this point, dehydration is a real concern. For example, recommended to lower the sugar concen- in sports such as motorcycle or Formula 1 racing, great tration to 4-6% and increase the salts (to concentration and continuous hydration are required20. 0.7 to 1 g /L) to prevent hyponatremia. On the other hand, hyperhydration (usual in enduran- ce races and especially in women) could be dangerous also21. Hyperhydration is commonly associated with Table II hyponatremia. It may cause cerebral edema or respi- Characteristics of sports drinks (before, during, and after the training). ratory failure22. Dilutional hyponatremia is characte- rized by a lower plasma sodium concentration (<135 Before During After mEq/L). The probability of these disorders increases Isotonic or at 6-8 hours (at more than 30°C and high relative hu- Isotonic Hypertonic slightly hypotonic midity, 55%), and they are associated with inadequate 7 8 heat acclimatization, excessive loss of sodium, and ex- 4-6% sugars 6-9% sugars 9-10% sugars cessive intake of water or hypotonic drinks. This event 0.5-0.7g Na/L5 0.5-0.7g Na+/L7 1-1.5g Na+/L8 also occurs with hypertonic drinks used after sporting + 23 0.7-1.2 Na /L. (if events . longer than 1 hour or Sometimes, despite knowing that during the physi- under heat stress) cal activity it is not adequate for the maintenance of a proper fluid balance, certain athletes drink only water 4 Furthermore, most of the studies in this area have because of sponsorship by water brands . To maximize concluded that fluid intake should occur during physi- the absorption of water during exercise, an additional, cal activity and that a deficit of 0.4-0.6 L/h is common, small amount of glucose and also sodium (Na) should depending on the energy expenditure during the phy- be provided, in the form of isotonic sports drinks (ta- sical activity and the environment24. It is noteworthy ble I) with characteristics that are described below2, that dehydration occurs in sports activities (minimum 5, 6. Hydration should be taken into account not only during exercise, but also before and after the activi- loss of 2-3%), during which the water absorption, hy- ty. So, sports drinks should be different according to dration, and nutrition are limited; therefore, gastroin- the chronology of the training/event. In general, these testinal problems, especially in ultra-resistance sports 25 drinks should be: 1) hypotonic drinks before training competitions, can be generated . and/or competition, 2) isotonic drinks during exerci- Among the diuretic drinks, the intake of alcoholic se, and 3) slightly hypertonic drinks after the training/ drinks (containing more than 2% alcohol) may cause competition 5. Table II clarifies the chemical composi- disorders - owing to the diuretic effect in the orga- tion of sports drinks taken before, during, and after the nism26. In this context, the diuretic effects of caffeine training5, 7, 8. have also been described, but Maughan and collea- 1890 Nutr Hosp. 2015;31(5):1889-1899 Aritz Urdampilleta et al. 001_7867 Hydration and chemical ingredients.indd 1890 15/04/15 07:33 gues27 observed that this effect may be even greater in gulation (EC) No 953/2009 specifies a positive list of sportsmen who do not take caffeine habitually. Howe- substances that can be added to the dietary products, ver, its diuretic effect is hardly appreciable in sports- due to identified legal loopholes12. Particularly, this list men and other people who take 2-3 servings of coffee is designed for the authorized preparation of food pro- (200-300 mg caffeine) per day. In recent