Results from a new study1 published in the American Journal of Clinical Nutrition (AJCN), indicate that two alternative rehydration drinks may outperform the hydrating ability of brand-name sports drink Gatorade. In the study, a sugar-free amino acid beverage, known commercially as enterade ORS (Entrinsic Health Solutions; Norwood, MA), and a glucose-based beverage (Pedialyte), both provided better hydration than Gatorade when compared using a new analysis tool called the beverage hydration index (BHI).
The beverage hydration index is a relatively newly established tool for assessing the hydration effects of different beverages. According to the study researchers, details about the BHI metric were published2 in March 2016, also in the American Journal of Clinical Nutrition. According to the authors, the BHI is a metric designed to assess the short-term hydration potential of different beverages when consumed in the euhydrated state, or the normal state of body water content. BHI measures the volume of urine that a subject produces after drinking a hydration beverage relative to a baseline treatment (such as water).
Researchers of the current AJCN study point out that, prior to this study, there were still unanswered questions as to how subjects’ differing sex or body mass impacted the BHI’s ability to accurately measure and compare index results. In this study, researchers sought first to determine the impact of body mass and sex on subjects’ BHI levels using enterade ORS, Pedialyte, Gatorade, and water (control). While the primary endpoint was to determine the efficacy of the BHI index for assessing hydration, the results also shed light on which beverages provided the greatest hydration compared with water.
Researchers gave 40 male and female subjects 1 L of each test beverage at four separate testing visits. After consuming 1 L of each beverage, researchers measured subjects’ urine output immediately following ingestion of the beverage, and then at one-hour intervals for the next four hours. Researchers calculated subjects’ BHI levels as a ratio of each participant’s cumulative urine output after drinking 1 L of water over their cumulative output after drinking each of the other three beverages.
The results showed that subjects’ body mass and sex had no impact on BHI. “Our results demonstrated that although, on average, the females were lighter than the males and took in a larger relative fluid bolus during the testing (mL/kg), there were no differences in BHI values between the sexes, nor were there any differences due to body mass per se within the ranges tested. Therefore, there was no independent impact of body mass or sex on the BHI,” the researchers wrote.
In addition, wrote the study authors, “our results demonstrate that a novel AA-ORS [enterade ORS] and a traditional G-ORS [Pedialyte] hydrate better than water, while a traditional SpD [Gatorade sports drink] does not.” Further, not only did the enterade ORS beverage score higher on the BHI index, but it also achieved hydration with less calories and no sugar, they pointed out.
According to Entrinsic Health Solutions, the implications of the study results are twofold: first, the results show that Gatorade, which is sold as a hydration beverage, does not achieve the optimal levels of hydration compared to the other two test beverages. In fact, says the company, the added sugar often included in Gatorade may be detrimental to consumers’ health.
Second, the results indicate that there are more options for consumers looking for hydrating beverages. Beverage manufacturers can also use these study results to develop healthier, all-natural hydration beverages, Entrinsic Health Solutions says.
“Importantly, the AA-ORS [enterade ORS] contains no sugar and minimal calories, which gives this beverage potential robust application for a number of clinical populations,” the researchers wrote in the study.
One of those applications, says Entrinsic Health Solutions, is in oral rehydration therapy. Because there is currently a supply shortage of IV fluids in the U.S., it says, doctors are now seeking alternatives for hydrating patients. Oral rehydration therapy is a method of rehydration in which patients choose between several kinds of beverages. Some of the benefits of such a system include avoiding pain from IV insertion, ease-of-use, and lower costs. The new study results, says the company, may help inform patients’ choice of beverage in rehydration therapy.
- Sollanek KJ et al., “Neither body mass not sex influences beverage hydration index outcomes during randomized trial when comparing 3 commercial beverages,” American Journal of Clinical Nutrition, vol. 107, no. 4 (April 2018): 544-549
- Maughan RJ et al., “A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. American Journal of Clinical Nutrition, vol. 103, no. 3 (March 2016): 717-723