National athletic trainers' association position statement: Fluid replacement for the physically active

Brendon P. McDermott, Scott A. Anderson, Lawrence E. Armstrong, Douglas J. Casa, Samuel N. Cheuvront, Larry Cooper, W. Larry Kenney, Francis G. O'Connor, William O. Roberts

Research output: Contribution to journalReview articlepeer-review

178 Scopus citations


Objective: To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals. Background: Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluidreplacement strategies for physically active individuals. Recommendations: Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

Original languageEnglish (US)
Pages (from-to)877-895
Number of pages19
JournalJournal of Athletic Training
Issue number9
StatePublished - Sep 2017

Bibliographical note

Funding Information:
Brendon P. McDermott, PhD, ATC, FACSM, serves on the Medical and Science Advisory Board of the Korey Stringer Institute (Storrs, CT) and the Advisory Board for the Kendrick Fincher Hydration for Life foundation (Rogers, AR). Scott A. Anderson, ATC, is a member of the Gatorade Sports Science Institute’s Speaker Bureau (Barrington, IL). Lawrence E. Armstrong, PhD, FACSM, is a consultant to, member of the Scientific Advisory Board of, and has received grant funding from Danone Research (Palaiseau, France); he is also a consultant to the Drinking Water Research Foundation (Alexandria, VA). Douglas J. Casa, PhD, ATC, FNATA, FACSM, is a consultant to Gatorade (Chicago, IL); Clif Bar & Co (Emeryville, CA); Jones & Bartlett (Burlington, MA); UpToDate (Alphen aanden Rijn, The Netherlands); Springer International Publishing AG (Berlin, Germany); Lippincott Williams & Wilkins (Philadelphia, PA); Quest Diagnostics (Madison, NJ); and Sports Innovation Lab (Boston, MA); a member of the Scientific Advisory Board of Clif Bar & Co, the National Football League (New York, NY), CamelBak (Petaluma, CA), Quest Diagnostics, Nix Inc (Boston, MA), and Sports Innovation Lab; and has received grant funding from Gatorade; Kestrel Corporation; the National Football League; (New Milford, CT); Mission Product Holdings, Inc (New York, NY); Jones & Bartlett; Quest Diagnostics; General Electric (Boston, MA); Nix Inc; the US Air Force (Washington, DC); the US Army (Washington, DC); Halo Wearables (San Francisco, CA); WHOOP, Inc (Boston, MA); the National Collegiate Athletic Association (Indianapolis, IN); Danone Research; Timex Group USA, Inc (Middlebury, CT); Eagle Pharmaceuticals, Inc (Woodcliff Lake, NJ); the National Athletic Trainers’ Association (Carrollton, TX); the National Center for Catastrophic Sport Injury Research (Chapel Hill, NC); dhama Innovations Pvt Ltd (Hyderabad, India); and Polar Electro Inc (Lake Success, NY). He has also provided expert testimony in approximately 35 lawsuits since 2010. Samuel N. Cheuvront, PhD, RD, FACSM, is a consultant to PepsiCo (Purchase, NY); Nike (Beaverton, OR); Entrinsic Health Solutions, Inc (Norwood, MA); and Bitome, Inc (Boston, MA) and a member of the Scientific Advisory Board of Bitome. Larry Cooper, MS, ATC, is a consultant to Gatorade. W. Larry Kenney, PhD, FACSM, is a member of the Scientific Advisory Board of the American Council on Exercise (San Diego, CA) and has received grant funding from Entrinsic Health Solutions, Inc, and the Dairy Research Institute (St Paul, MN). Francis G. O’Connor, MD, MPH, has no conflicts to declare. William O. Roberts, MD, MS, FACSM, is a member of the Scientific Advisory Board of Race Safe, SportzPeak Inc (San Francisco, CA).

Publisher Copyright:
© by the National Athletic Trainers' Association, Inc.


  • Athletic performance
  • Dehydration
  • Fluid overload
  • Hydration protocol
  • Hydration status
  • Hyponatremia
  • Oral rehydration solution
  • Overhydration
  • Rehydration


Dive into the research topics of 'National athletic trainers' association position statement: Fluid replacement for the physically active'. Together they form a unique fingerprint.

Cite this