Jn142000 1.7
The Journal of Nutrition. First published ahead of print December 21, 2011 as doi: 10.3945/jn.111.142000.
The Journal of Nutrition
Ingestive Behavior and Neurosciences
Mild Dehydration Affects Mood in HealthyYoung Women1,2
Lawrence E. Armstrong,3 Matthew S. Ganio,3,4 Douglas J. Casa,3 Elaine C. Lee,3 Brendon P. McDermott,3,7Jennifer F. Klau,3 Liliana Jimenez,5 Laurent Le Bellego,5 Emmanuel Chevillotte,5and Harris R. Lieberman6*
3University of Connecticut, Human Performance Laboratory, Storrs, CT; 4University of Arkansas, Department of Health, HumanPerformance, and Recreation, Fayetteville, AR; 5Danone Research, R&D Waters, Palaiseau France; and 6U. S. Army Research Institute ofEnvironmental Medicine, Military Nutrition Division, Natick, MA
Limited information is available regarding the effects of mild dehydration on cognitive function. Therefore, mild
dehydration was produced by intermittent moderate exercise without hyperthermia and its effects on cognitive function of
women were investigated. Twenty-five females (age 23.0 6 0.6 y) participated in three 8-h, placebo-controlled
experiments involving a different hydration state each day: exercise-induced dehydration with no diuretic (DN), exercise-
induced dehydration plus diuretic (DD; furosemide, 40 mg), and euhydration (EU). Cognitive performance, mood, and
symptoms of dehydration were assessed during each experiment, 3 times at rest and during each of 3 exercise sessions.
The DN and DD trials in which a volunteer attained a $1% level of dehydration were pooled and compared to that
volunteer's equivalent EU trials. Mean dehydration achieved during these DN and DD trials was 21.36 6 0.16% of body
mass. Significant adverse effects of dehydration were present at rest and during exercise for vigor-activity, fatigue-inertia,
and total mood disturbance scores of the Profile of Mood States and for task difficulty, concentration, and headache as
assessed by questionnaire. Most aspects of cognitive performance were not affected by dehydration. Serum osmolality, a
marker of hydration, was greater in the mean of the dehydrated trials in which a $1% level of dehydration was achieved (P
= 0.006) compared to EU. In conclusion, degraded mood, increased perception of task difficulty, lower concentration, and
headache symptoms resulted from 1.36% dehydration in females. Increased emphasis on optimal hydration is warranted,
especially during and after moderate exercise.
J. Nutr. doi: 10.3945/jn.111.142000.
healthy individuals during their ordinary daily activities, de-
Adequate fluid intake and homeostasis of total body water is
grades cognitive performance, alters mood, or produces adverse
essential for human health and survival, including maintaining
brain function. Severe dehydration clearly produces decrements
Many studies use heat and exercise to produce dehydration.
in cognitive function (1,2). For example, clinical observations
One of the most comprehensive (ambient temperature of 458C
demonstrate severe dehydration results in acute confusion and
with 30% RH8) assessed the effects of dehydration ranging from
delirium (3). However, insufficient research has been conducted
1 to 4% in 1% increments in 11 healthy, young males aged 20–
to determine if mild dehydration, at levels that may occur in
25 y (4). A serial addition test, word recognition test, and trail-making test were administered; all detected deterioration at 2–4% dehydration. A similar study (5) assessed the effects of
1 Supported by Danone Research, Palaiseau, France.
2
dehydration at ;1, 2, and 3% body mass loss in 8 young males.
Author disclosures: L. Armstrong is a Danone Research Scientific Advisory
Moderate exercise in the heat induced dehydration and behav-
Board member, paid consultant. H. Lieberman serves as a consultant toDanone Research but was not compensated for his contributions to this study. L.
ioral testing was conducted in three environments: thermoneu-
Jimenez, L. Le Bellego, and E. Chevillotte are employed by Danone Research. M.
tral (378C, 50% RH), hot dry (458C, 30% RH), and hot humid
Ganio, D. Casa, E. Lee, B. McDermott, and J. Klau, no conflicts of interest. The
(398C, 60% RH). Tests included symbol substitution, concen-
views, opinions and/or findings in this report are those of the authors, and should
tration, and eye-hand coordination. Effects of dehydration were
not be construed as an official Department of the Army position, policy ordecision, unless so designated by other official documentation. Citation of
observed in two of three tests at 2 and 3% dehydration, but, in
commercial organization and trade names in this report do not constitute anofficial Department of the Army endorsement or approval of the products orservices of these organizations.
7 Present address: Department of Health and Human Performance, University of
8 Abbreviations used: DD, dehydration with diuretic treatment condition; DN,
Tennessee at Chattanooga, Chattanooga, TN 37403.
dehydration with no diuretic treatment condition; EU, euhydrated treatment
* To whom correspondence should be addressed. E-mail: harris.lieberman@us.
condition; POMS, Profile of Mood States; PVT, psychomotor vigilance task; RH,
relative humidity; Tgi, gastrointestinal temperature; VAS, visual analogue scale.
ã 2012 American Society for Nutrition.
Manuscript received March 28, 2011. Initial review completed April 22, 2011. Revision accepted November 9, 2011.
Copyright (C) 2011 by the American Society for Nutrition
the symbol substitution test, effects were observed only at 3%
in the placebo phase of their contraceptive schedule. Because experi-
dehydration (P , 0.05). Other studies assessed information
ments were separated by 28 d to control for the menstrual cycle, males
processing during simulated sporting events with similar out-
were not tested in this study. However, a separate study of males was
comes (6–8); dehydration (from 21 to 24% body mass)
conducted using a similar protocol during a different period of time.
impaired mood, choice reaction time, and vigilance. Collec-
Procedures. To become familiar with study procedures, each partici-
tively, these studies provide insight into the effects of mild-to-
pant visited the laboratory for 3–5 preliminary sessions to practice
moderate dehydration on cognitive performance but not a clear
cognitive tests and behavioral testing on a desktop computer while
indication of which aspects of cognitive performance are most
sitting at a workstation and a laptop computer while walking on a
affected by dehydration or its effects on mood, perceived effort,
treadmill. When a woman's cognitive performance reached an asymp-
or symptoms. Furthermore, the high levels of heat used to induce
tote on 2 consecutive days, she could participate in experiments.
dehydration may have interacted with dehydration to exacer-
Participants were instructed regarding adequate fluid intake and
bate degradation of cognitive performance (1).
sleep prior to each experiment and refrained from consuming caffeine
The present investigation used a battery of tests of cognitive
and alcohol for 12 h prior to each. To ensure all participants began each
performance, mood, perceived exertion, and symptoms sensitive
experiment in a euhydrated state, they consumed 240 mL of supple-
to various environmental and nutritional factors, including mild
mental mineral water (i.e., above their usual/habitual water intake) onthe night before testing and 240 mL of mineral water upon waking on
dehydration (9–11). To avoid confounding effects of high heat
the morning of testing. This was supplied as Volvic Natural Mineral
exposure, mild dehydration was induced by moderate exercise in
Water (Danone), which contained the following dissolved substances
a moderately warm environment (mean 6 SD, 27.6 6 0.88C).
(mg/L): calcium, 10; chloride, 8; bicarbonate, 65; magnesium, 6; nitrate,
Physiological variables associated with hydration state were also
1; potassium, 6; silica, 30; sodium, 9; and sulfates, 7 (109 mg/L of total
assessed. Volunteers were healthy, young females.
dissolved solids). The mineral water also was consumed with a
A problem with previous work in this area is the difficulty
standardized breakfast and during the experiments (see below). Further,
designing a double-blind study of dehydration (1). Therefore,
participants consumed the same meals for 24 h prior to each experiment
this study disguised the treatment conditions from volunteers
to reduce the effects of variation in nutritional intake on outcome
and investigators responsible for testing by using several
variables. The foods and beverages consumed prior to the first
procedures. Inclusion of a positive control condition, dehydra-
experiment (i.e., self-selected by each participant) were duplicated forthe second and third experiments. Compliance was verified with dietary
tion induced by combination of a diuretic and exercise, disguised
records of all food and beverages consumed during the 24 h before each
the experimental conditions, because in one of two dehydration
experiments, volunteers lost substantial fluid in urine. To further
On the morning of each experiment, participants reported to the
blind the experimental conditions, a pill (either diuretic or
laboratory at 0800 or 0900 h and, after a blood sample was collected,
placebo) was administered prior to every experiment and some
consumed one capsule under the supervision of an investigator. Capsules
fluid, with the volume disguised, was consumed. We hypothe-
were prepared by a licensed pharmacist (Compounded Solutions in
sized mild dehydration would primarily affect mood and
Pharmacy), were identical in appearance, and contained either a diuretic
symptoms of dehydration and have modest effects on cognitive
(40 mg furosemide; Lasix) or placebo. Volunteers reported at two
different times so testing could be staggered (times provided in the textare for women starting at 0800 h). Participants rested quietly in ananteroom adjacent to the testing rooms and consumed no food until1000 h when a standardized breakfast was provided; it contained ;700
kcal (2929 kJ9) + 174 mL mineral water. They also consumed two smallfood bars as snacks [210 kcal (879 kJ)/feeding] immediately after the first
Participants. Twenty-five females (age, 23.0 6 0.6 y; body mass, 63.0 610.3 kg) attended an informational briefing and gave informed voluntary
(1350 h) and second (1550 h) cognitive test batteries. A blood sample
consent to participate in this study, which was approved by the
was also collected at 1750 h.
University of Connecticut Institutional Review Board for Human
At 1200, 1400, and 1600 h, participants entered the environmental
Studies. The women were selected from 30 volunteers. Any woman
chamber and began 40 min of dehydrating exercise (described below)
who consumed an extreme diet, had evidence of disordered eating, was
then rested for 20 min. Participants began identical cognitive test
taking medications that altered fluid-electrolyte balance, was restricting
batteries at 1300, 1500, and 1700 h. In the DN and DD experiments, the
caloric intake, or had a chronic disease (e.g., renal dysfunction) was
women consumed no water to replace water loss in urine or sweat,
excluded from participation. Use of oral contraceptives for at least three
except for 50 mL after completing the first and second cognitive test
consecutive months prior to this investigation was an inclusion criterion.
batteries, to wet their palates and disguise the experimental condition.
Test participants were physically fit (i.e., could complete three walking
Procedures in the EU experiment were identical to the DN and DD
exercise sessions/d) but were neither highly trained nor totally sedentary.
experiments except fluid lost in urine and sweat was replaced by
Prior to this investigation, most participated in 30–60 min of exercise on
consuming an equal volume of mineral water during and after each
2–4 d/wk. All participants spoke English as their primary language.
exercise bout based on the individual's loss during that session. Ambientlaboratory environmental conditions were controlled and monitored. Inthe anteroom outside the environmental chamber and in the cognitive
Experimental design. In this crossover study, women participated in 3-day-long laboratory experiments: 1) exercise-induced dehydration plus
testing room, air temperature was maintained at 23.08C. Fluid lost in
placebo capsule containing no diuretic (DN); 2) exercise-induced
urine during the experiment was assessed by collecting each woman's
dehydration plus a diuretic capsule (DD); and 3) euhydration plus
total urine output. Sweat loss was calculated as the difference in body
placebo capsule (EU). The order of assignment to each of the experi-
mass, corrected for urine production and fluid intake.
ments was randomized. All experiments involved an identical exerciseregimen, described below. A third party, not involved in data collection,
Exercise dehydration protocol. Participants performed 40 min of
randomized and counterbalanced the order of experiments. Test partic-
treadmill walking (5.6 km/h, 5% grade) in a moderate-warm environ-
ipants as well as investigators in the environmental chamber were
ment to produce body mass loss without inducing hyperthermia. Inside
unaware of the treatments, but an investigator who monitored water
the environmental chamber, where dehydrating exercise sessions were
administration was not. The 3 experiments were conducted ;28 d apart
conducted, the air temperature was 27.6 6 0.88C, the RH was 49.4 6
during the 7-d placebo phase of each woman's oral contraceptiveschedule. Prior to each experiment, participants presented their emptyoral contraceptive pill packs to a female investigator to verify they were
9 1 kcal = 4.184 kJ.
Armstrong et al.
6.9%, and the wind speed was 3.5 m/s as provided by a floor fan. Body
preliminary practice sessions, each volunteer's performance was adjusted
mass was measured (650 g) every 13 min during exercise when
to a criterion of 60% correct detections.
participants briefly stepped off the treadmill onto a floor scale (Health-ometer model 349KLX). Heart rate was measured every 10 min with a
PVT. This is a test of simple visual reaction time (16). A series of stimuli
chest cardiotachometer (model S150, Polar Instruments). The T
are presented at random intervals on a screen and the participant
measured every 10 min of exercise by using an ingestible temperature
responds as rapidly as possible when a stimulus appears. Reaction time,
sensor (CorTemp, HQ). On the morning of each experiment, each
false alarms, and number of lapses (long duration responses) are
participant swallowed the sensor upon arrival to the laboratory. After
recorded. The test requires sustained attention and responses, performed
every exercise session, participants left the environmental chamber,
by pressing a button in a timely manner, in response to a randomly
moved to a comfortable room (23.08C, dimly lit, quiet), dried their skin
appearing stimulus on the computer screen. This is the only portion of
and hair with a towel, and rested on a chair for 20 min.
the cognitive test battery that was administered during treadmill
The rating of perceived exertion scale [6–20 point scale (12)] was
administered at 40 min of exercise; the extreme options on this scalewere "very, very light" and "very, very hard." At the same time, a
Four-choice visual reaction time test. Choice reaction time tasks are
perceived leg muscle pain intensity rating was obtained from each
sensitive to the effects of nutritional factors on cognitive performance
woman (13). This scale ranged from 0 ("no pain at all") to 10
(10,17–19). Volunteers are presented with a series of visual stimuli at one
("extremely intense pain, almost unbearable") and offered one unnum-
of four different spatial locations on a computer screen. They indicate
bered rating option beyond 10 ("unbearable pain").
the correct spatial location of each stimulus by pressing one of four
To disguise the experimental condition, participants were unaware of
adjacent keys on the computer keyboard. Correct responses, incorrect
their body mass, urine volume, and ingested fluid volume during
responses, response latency, premature errors, and time-out errors (i.e.,
experiments. This was accomplished by obscuring the body mass scale
response latency . 1 s) are recorded for each test administration.
dial, collecting urine in individual aliquots and removing these samplesfrom the room before placement in the urine collection container, and by
Matching to sample test. This test assesses short-term spatial memory
providing mineral water in opaque, covered containers. In spite of these
(working memory) and pattern recognition skills (17,20). The volunteer
efforts, differences in urine flow between conditions may have been
is presented with a matrix of a red and green checkerboard on a color
detectable by the women. However, upon completion of all testing,
screen. The matrix appears on the screen for 4 s, then is removed during a
volunteers were not able to distinguish between the hydrated and
variable delay involving a blank screen. After the delay, two matrices are
presented on the screen: the original sample matrix and a second matrixthat differs slightly (i.e., the color sequence of two of the squares is
Physiological variables at rest. A urine sample was collected shortly
reversed). The volunteer selects the comparison matrix by touching keys
after participants arrived at the laboratory (0800 h) for evaluation of
that match the original sample matrix. The task lasts 5 min. If a
urine specific gravity via a hand-held refractometer. Immediately
response is not made within 15 s, a time-out error is recorded. Correct
preceding the final cognitive test battery, the T
responses and the response time to choose a matrix also are recorded.
gi was recorded at rest
(see previous section). A blood sample was collected when participantsarrived at the laboratory (0800 h) and after the third cognitive test
Repeated acquisition test. This test assesses learning and short-termmemory (17). The volunteer is required to learn a sequence of 12 key
battery (1700 h). Osmolality was measured in both samples; lactate,
presses on the four arrow keys of a computer; this task requires 10 min.
glucose, and cortisol were measured in the 1700-h sample. Osmolalitywas measured in duplicate using a freezing-point depression osmometer
The outline of a rectangle is presented on the screen at the beginning of a
(model 3250, Advanced Instruments). Lactate and glucose were
test. Each correct response fills in a portion of the rectangle with a solidyellow color, from left to right. Each incorrect response blanks the screen
analyzed (YSI 2300 Stat Plus) in duplicate using an automated enzymatictechnique. Cortisol was analyzed using a competitive cortisol enzyme
for 0.5 s. When the screen returns, the volunteer is at the same point in
immunoassay technique (ELISA, DSL-10–2000; Diagnostic Systems
the sequence as before the incorrect response. The volunteer has to learn
the correct sequence by trial and error. When a sequence is correctlycompleted, the rectangle fills, the screen blanks, and another emptyrectangle reappears for the next test. A test ends when the volunteer
Cognitive test battery. Behavioral tasks were selected that assessed abroad spectrum of cognitive functions, from simple abilities to complex
completes 15 correct sequences. Each test consists of a new sequence that
skills, including vigilance, reaction time, learning, working memory, and
is randomly selected from a list of 32 different sequences. Incorrectresponses and time to complete each test are recorded.
logical reasoning. Mood states and symptoms were also assessed. Testingwas conducted 20 min after completing each exercise session in a quiet,
Grammatical reasoning. This 5-min test assesses language-based
dimly lit room (23.08C) and took 45–50 min to complete. Computerized
logical reasoning and has been used to assess the effects of various
tasks (NTT Systems; Cognitive Test Software, version 1.2.4) were
treatments on cognitive function (21). On each test, a logical statement,
administered in the same order during each experiment.
such as "A is preceded by B," is followed by the letters AB or BA. Thevolunteer decides whether each statement correctly describes the order of
Cognitive testing at rest. Testing at rest was conducted using desktop
the two letters. The "T" key on the keyboard is pressed to indicate that a
computer systems running the Windows operating system. Visual stimuli
statement is true and the "F" key is pressed to indicate that a statement is
were presented on 49-cm (diagonal) LCD monitors (Acer model
A1716F). Participant responses were input using keyboards (RazerTarantul, model RZ03–00070100-R2U1) that recorded responses with a
POMS questionnaire. The POMS is a widely used, brief, standardized
1-ms response latency.
inventory of mood states (22). It is sensitive to a wide variety ofnutritional manipulations, environmental factors, sleep loss, and sub-
Scanning visual vigilance task. This test is sensitive to a wide variety
clinical drug doses (14,17–20,23). The volunteers rate a series of 65
of environmental conditions, nutritional factors, sleep loss, and very low
mood-related adjectives on a five-point scale, in response to the question,
doses of hypnotic drugs and stimulants (14,15). The participant
"How are you feeling right now?" The adjectives factor into six mood
continuously scans a computer screen to detect the occurrence of stimuli
subscales (tension-anxiety, depression-dejection, anger-hostility, vigor-
that are infrequent and difficult to detect. The volunteer detects a faint
activity, fatigue-inertia, and confusion-bewilderment). A computerized
stimulus that appears randomly on a computer screen, approximately
version of the POMS was administered during treadmill exercise and
once per minute, then presses the space bar on the keyboard as rapidly as
during seated rest.
possible. The computer records whether or not a stimulus is detected andthe response time (in milliseconds). Responses made .2 s after a
VAS. To complete these scales, the participant placed a mark on a 100-
stimulus was presented were recorded as false alarms. During the
mm line between extreme answers at opposite ends of the line. The
Mild dehydration, mood, and cognitive performance
extreme answers were "very strong(ly)" and "not at all strong(ly)." The
Morning body mass, urine specific gravity, and sleep
questions were, "How hard was the effort required to complete these
status of female volunteers prior to testing in the
tests?," and "How hard did you have to concentrate to accomplish the
dehydration ($1%) or the EU condition1,2
tasks successfully?" Headache symptoms also were evaluated at the endof each cognitive test trial by rating the statement, "I have a headache."
Cognitive testing during exercise. In addition to cognitive testing atrest, during each treadmill walking session, three tests, the POMS, VAS,
and PVT, were administered on a laptop computer (Sony, Vaio, model
Urine specific gravity
PCG-5G3L) placed on a stationary platform suspended in front of the
Previous night's sleep, h
participant while she walked at the required pace. Participants
responded using a Razer DeathAdder mouse (model RZ01–00150100-
Values are mean 6 SD, n = 25 or 24 (sleep, due to a missing value in the EU
R3M1) with a 1-ms response time.
condition). Data were analyzed using paired t tests that compared the dehydratedbaseline values of each volunteer to that volunteer's EU values. DD, dehydration with
diuretic treatment condition; DN, dehydration with no diuretic treatment condition; EU,
Statistical methods. Statistical analyses were performed using IBM
euhydrated treatment condition.
SPSS Statistics v19.0. Due to variability in rate and extent of dehydration
2 For the dehydrated conditions, DN and DD data were averaged if $1% dehydration
over the course of the DN and DD experiments, statistical comparisons
was achieved at any time point during data collection.
for all dependent variables were conducted only when a volunteer
attained a level of dehydration $ 1% body mass loss. A criterion of 1%was established, because this is the lowest level of dehydration that has
hostility (P = 0.04) and fatigue-inertia (P = 0.003) as well as a
been suggested as capable of altering cognitive function (1,4,5).
decrease in vigor-activity (P = 0.03) (Table 2) when dehydrated.
Variability was expected, because dehydration was induced by
The aggregate measure of POMS ratings, the total mood
moderate exercise in a temperate environment in the absence of
disturbance score also deteriorated when women were dehy-
hyperthermia. To determine whether levels of dehydration induced
drated (P = 0.01). The 3 VAS administered also detected adverse
during DD trials compared to DN trials of $1% body mass loss were
effects of dehydration [perceived task difficulty (P = 0.004);
different, a paired t test was conducted comparing the change of plasma
concentration (P = 0.01); headache (P = 0.05)]. During exercise,
osmolality, a standard measure of hydration status, of these conditions atthe completion of testing. The increase in osmolality from the beginning
adverse effects of dehydration on the POMS subscales and VAS
to end of the test day was nearly identical in the DN (11 6 9 mOsm/kg)
also were observed (P # 0.05) (Table 3).
and DD (10 6 6 mOsm/kg; P = 0.58) trials. In addition, a CI-based
Physiological measurements revealed that post-exercise Tgi
equivalence test demonstrated that the small difference in percent body
and heart rate were greater (P , 0.001) following mild
mass changes in DN (21.38 6 0.20%) compared to DD (21.37 6
dehydration ($1%) (Table 4). Resting Tgi, immediately before
0.17%) were equivalent (,0.2%; P = 0.93). Therefore, data from the
cognitive test administration was greater (P = 0.004) when
DN and DD conditions were pooled for analysis.
participants were mildly dehydrated. The change of plasma
Results from cognitive tests in which participants had $1.0% body
osmolality throughout the experimental day (0800 to 1750 h)
mass loss were combined, regardless of whether the dehydration
also was greater during $1% than during EU (P = 0.006);
occurred in the DN or DD trial, and were compared using a paired
however, plasma concentrations of lactate, glucose, and cortisol
samples t test to the mean of the corresponding EU tests. This procedureresulted in #25 data pairs. A P value of #0.05 (2-tailed) was the
were similar across these experimental conditions (Table 4).
criterion for significance. Values in the text are means 6 SD.
When female volunteers, at rest or during exercise, were
dehydrated (mean loss of 1.36% body mass), vigor, fatigue, and
When participants reported for testing at 0800 h each day,
aggregate mood, assessed by total mood disturbance score, were
there were no differences between treatment conditions in body
adversely affected. Perception of task difficulty and headache
mass, urine specific gravity, or self-reported sleep duration
severity increased and ability to concentrate decreased when
volunteers were dehydrated compared to their own EU (control)
For the DN and DD trials that resulted in a $1% weight loss,
trials, at rest, and during exercise. Performance on most aspects
mean body mass decreased (21.36 6 0.16%). For the EU
of cognitive function assessed, including psychomotor vigilance,
experiments, the fluid replacement regimen was deemed suc-
reaction time, working memory, and reasoning, was not affected
cessful, because body mass declined very little (20.12 6
during mild dehydration with the exception of a small increase
0.05%); for our test participants, this difference was equivalent
in visual vigilance false alarm errors.
to 48 mL of water in a total body water of 39.69 L (24).
Limited data are available on mood, cognitive performance,
Cognitive performance was for the most part not affected by
ability to concentrate, headache, and perception of task
mild dehydration. There were no significant changes in the
difficulty when volunteers are at rest or actively exercising in a
scanning visual vigilance task with one exception (false alarms),
mildly dehydrated state. This study demonstrates that, not only
PVT, four-choice reaction time test, matching to sample,
at rest but also during moderate exercise, a wide variety of
repeated acquisition, and grammatical reasoning task (Table 2)
adverse changes occur in slightly dehydrated, young, healthy
at rest. The single aspect altered on the scanning visual vigilance
females. These may, in theory, interfere with motivation to
task was false alarm errors (P = 0.02), which slightly increased in
continue exercise or other activities. Our findings are consistent
the dehydrated condition (Table 2). During exercise on the
with a study conducted by Szinnai et al. (11) in which
treadmill, performance on the PVT was not affected by
dehydration was induced by fluid restriction for 28 h, resulting
dehydration (Table 3).
in a mean dehydration level of 2.6% body mass loss. In that
When testing was conducted on a desktop computer at rest (i.
study, aspects of mood similar or identical to those we assessed
e., quiet room that was adjacent to the environmental chamber,
were degraded, with tiredness increasing and alertness and
23.08C, dimly lit), 3 of the 6 POMS subscales were adversely
perceived ability to concentrate declining. As in our study, the
affected by dehydration. Participants reported increased anger-
perceived effort necessary for task accomplishment increased
Armstrong et al.
Cognitive performance, mood, and VAS ratings of
Vigilance, mood, perceptions of performance and
female volunteers at rest in a quiet, dimly lit room
symptoms reported during treadmill walking in
during EU and dehydrated conditions1
female volunteers during EU and dehydratedconditions1,2
Cognitive tests and
Cognitive tests and
Scanning visual vigilance
Correct responses, n
Psychomotor vigilance test
Premature errors, n
Psychomotor vigilance test
Premature errors, n
Four-choice reaction time
Incorrect responses, n
Time-out errors, n
Matching to sample
Total mood disturbance
Correct responses, n
Time-out errors, n
Repeated acquisition
Incorrect responses, n
Time to complete, s
Grammatical reasoning
1 Values are means 6 SD, n = 25 comparisons. The number of women dehydrated
Correct responses, n
$1% in DN after exercise bout 1 was n = 2, after exercise bout 2 was n = 14, and after
Incorrect responses, n
exercise bout 3 was n = 24. In DD, no women were $1% dehydrated after exercise
bout 1; 8 women were dehydrated $1% after exercise bout 2, and 23 women weredehydrated $1% after exercise bout 3. DD, dehydration with diuretic treatment
condition; DN, dehydration with no diuretic treatment condition; EU, euhydrated
treatment condition; POMS, Profile of Mood States; PVT, psychomotor vigilance task;
RPE, rating of perceived exertion; VAS, visual analogue scale.
2 PVT and POMS data were recorded on a notebook computer mounted on a
stationary platform that was suspended in front of the participant during treadmill
3 P values resulted from paired t tests comparing EU trials to the corresponding mean
of DN and DD trials achieving dehydration of $1%.
Total mood disturbance
Information-processing when dehydrated during simulated
sporting events has also been investigated with similar findings
(6–8). During such events, dehydration (21 to 24% body mass)
impairs mood, choice reaction time, and vigilance. Although
1 Values are means 6 SD, n = 25 comparisons. The number of women dehydrated
these studies assessed effects of mild-to-moderate dehydration
$1% in DN after exercise bout 1 was n = 2, after exercise bout 2 was n = 14, and after
on cognitive performance during simulated sporting events, they
exercise bout 3 was n = 24. In DD, no women were $1% dehydrated after exercise
did not determine which aspects of cognitive performance are
bout 1; 8 women were dehydrated $1% after exercise bout 2, and 23 women weredehydrated $1% after exercise bout 3. DD, dehydration with diuretic treatment
most affected, nor did they assess perceived effort or symptoms
condition; DN, dehydration with no diuretic treatment condition; EU, euhydrated
of dehydration.
treatment condition; POMS, Profile of Mood States; VAS, visual analogue scale.
The physiological mechanism(s) responsible for deterioration
2 P values result from paired t tests comparing EU trials to the corresponding mean of
of mood and related factors due to dehydration is not known.
DN (exercise-induced dehydration with no diuretic) and DD (exercise-induced
dehydration plus diuretic) trials achieving dehydration of
Hypothalamic neurons detect dehydration (27) and may signal
higher-order cortical brain regions regulating mood when initialphysiological indicators of dehydration appear, resulting in
with dehydration. Cognitive performance was not affected in
adverse mood and symptoms. In humans, dehydration induced
that study, although some sex differences in performance were
by thermal stress in the same range as this study modified fronto-
noted (11). In addition to Szinnai et al. (11), other studies have
parietal blood oxygen level-dependent response assessed by
not found substantial changes in cognitive performance at
functional MRI without affecting cognitive performance (26).
dehydration levels ,2% body mass loss including one we
Given the critical physiological importance of maintaining
conducted in men (25,26). Our study demonstrates that a wide
hydration, adverse changes in mood and related perceptions
variety of mood states and symptoms are adversely affected at
may serve as a signal that evolved to alert humans before more
dehydration of 1.36% body mass loss, which is substantially less
severe consequences occur, such as degradation in performance.
than the 2.6% induced by Szinnai et al. (11). In addition, we
Once cognitive or physical performance is degraded, survival
detected adverse effects in ,8 h and these effects were present
may be affected, because the ability to find water or respond to
when individuals were both exercising and resting.
threats is diminished.
Mild dehydration, mood, and cognitive performance
Tgi, heart rate, and plasma constituents in female
dehydration (Tgi change of 0.38C, heart rate change of 9 bpm)
volunteers at the end of each experimental session
(Table 4) were minimal, making it unlikely that these factors
affected mood (37).
In conclusion, this study demonstrates that, in healthy young
women, mild levels of dehydration result in adverse changes in
key mood states such as vigor and fatigue as well as increasedheadaches and difficulty concentrating, without substantially
Postexercise Tgi,3 8C
altering key aspects of cognitive performance. Future studies
Postexercise heart rate,3 bpm
should determine the level of dehydration (i.e.,
loss) at which cognitive performance initially is degraded in
Resting plasma osmolality change,5 mOsm/kg
females and which aspects of cognition are most readily affected.
Resting plasma lactate,5 mmol/L
We also recommend that the effects of dehydration on cognition
Resting plasma glucose,5 mmol/L
be examined in young men and at-risk populations such as
Resting plasma cortisol,5 nmol/L
92.7 6 43.9 105.4 6 39.2
children, elderly individuals, and those with diabetes or stroke,
1 Values are means 6 SD, n = 25 (resting and postexercise Tgi), 24 (heart rate, lactate,
because those medical conditions can result in dehydration (33–
glucose, and cortisol, due to inability to complete a venipuncture), or 22 (osmolality,
due to equipment malfunction). DD, dehydration with diuretic treatment condition; DN,
dehydration with no diuretic treatment condition; EU, euhydrated treatment condition;
Tgi, gastrointestinal temperature.
2 Paired t tests compared EU trials to the corresponding mean of DN and DD trials
The authors thank Dr. Matthew Kramer and Christina E.
achieving dehydration of $1%.
3
Carvey for statistical assistance and Lauren A. Thompson for
At the end of the third 40-min exercise bout (27.68C air temperature).
technical assistance with manuscript revision and submission.
At rest, immediately before cognitive test administration (23.08C air temperature).
5 At rest, immediately after cognitive test administration (23.08C air temperature).
L.E.A., D.J.C., L.J., L.L.B., E.C., and H.R.L. designed research;L.E.A., M.S.G., D.J.C., E.C.L., B.P.M., and J.F.K. conducted
research; L.E.A., M.S.G., E.C.L., and H.R.L. analyzed data;
This study has a number of practical implications. Although
and L.E.A., M.S.G., and H.R.L. wrote the manuscript and had
cognitive performance was not substantially impaired in healthy,
primary responsibility for its final content. All authors read and
young females who were mildly dehydrated, key mood states
approved the final manuscript.
including vigor, fatigue, perception of task difficulty, concentra-tion, and headache were adversely affected by a small change inhydration. All these adverse effects were present during rest and
moderate exercise. Therefore, at least in females, maintenance ofoptimal hydration is essential to ensure optimal mood and
Lieberman HR. Hydration and cognition: a critical review andrecommendations for future research. J Am Coll Nutr. 2007;26:S555–
reduce symptoms, both at rest and during moderate exercise.
Healthy females may lose only 1.36% of body mass during daily
Maughan RJ. Impact of mild dehydration on wellness and on exercise
activities if they are not actively and regularly hydrating or are
performance. Eur J Clin Nutr. 2003;57:S19–23.
participating in exercise or sports, especially in a warm or hot
Wilson MM, Morley JE. Impaired cognitive function and mental
environment (28,29). Females may also be more readily affected
performance in mild dehydration. Eur J Clin Nutr. 2003;57:S24–9.
by modest levels of dehydration during phases of the menstrual
Gopinathan PM, Pichan G, Sharma VM. Role of dehydration in heat
cycle that disrupt fluid balance and alter mood (30,31). Changes
stress-induced variations in mental performance. Arch Environ Health.
1988;43:15–7.
in mood associated with premenstrual syndrome may be
Sharma VM, Sridharan K, Pichan G, Panwar MR. Influence of heat-
influenced by fluid shifts and the present data support this
hypothesis (32). In addition, individuals at risk of dehydration
due to age, infirmity, or medical conditions associated with
D'anci KE, Vibhakar A, Kanter JH, Mahoney CR, Taylor HA.
dehydration such as diabetes may experience adverse moods,
Voluntary dehydration and cognitive performance in trained college
increased perception of effort, and headache when minimally
athletes. Percept Mot Skills. 2009;109:251–69.
Dougherty KA, Baker LB, Chow M, Kenney WL. Two percent
The findings of the present investigation are unlikely to result
dehydration impairs and six percent carbohydrate drink improvesboys basketball skills. Med Sci Sports Exerc. 2006;38:1650–8.
from confounding factors, such as an expectation of adverse
Baker LB, Conroy DE, Kenney WL. Dehydration impairs vigilance-
effects of dehydration by volunteers or duration of exposure to
related attention in male basketball players. Med Sci Sports Exerc.
exercise and stress, because these were carefully controlled.
Procedures were implemented to ensure that volunteers and
Balkin TJ, Bliese PD, Belenky G, Sing H, Thorne DR, Thomas M,
investigators were unaware of each test condition, including an
Redmond DP, Russo M, Wesensten NJ. Comparative utility of instru-
active dehydrating drug treatment and placebo, as well as
ments for monitoring sleepiness-related performance decrements in theoperational environment. J Sleep Res. 2004;13:219–27.
administration of a small volume of mineral water in all
10. Lieberman HR, Bathalon GP, Falco CM, Kramer FM, Morgan CA III,
experiments. During a poststudy interview, volunteers could not
Niro P. Severe decrements in cognition function and mood induced by
identify test conditions. The within-participant design compared
sleep loss, heat, dehydration, and undernutrition during simulated
a woman's dehydrated behavioral data to her own hydrated
combat. Biol Psychiatry. 2005;57:422–9.
experiment and controlled for the confounding effects of
11. Szinnai G, Schachinger H, Arnaud MJ, Linder L, Keller U. Effect of
exercise duration or time of day. The effectiveness of the
water deprivation on cognitive-motor performance in healthy men andwomen. Am J Physiol Regul Integr Comp Physiol. 2005;289:R275–80.
experimental manipulations to induce dehydration was con-
12. Borg G. Perceived exertion as an indicator of somatic stress. Scand J
firmed by substantial increases in plasma osmolality during
Rehabil Med. 1970;2:92–8.
dehydration (Table 4). Osmolality is a widely used physiological
13. Cook DB, OConnor PJ, Eubanks SA, Smith JC, Lee M. Naturally
marker of hydration state in research studies and clinical settings
occurring muscle pain during exercise: assessment and experimental
(28,36). However, other physiological changes due to mild
evidence. Med Sci Sports Exerc. 1997;29:999–1012.
Armstrong et al.
14. Fine BJ, Kobrick JL, Lieberman HR, Marlowe B, Riley RH, Tharion
dehydration impairs cognitive performance and mood of men. Br J
WJ. Effects of caffeine or diphenhydramine on visual vigilance.
Psychopharmacology (Berl). 1994;114:233–8.
26. Kempton MJ, Ettinger U, Foster R, Williams SC, Calvert GA,
15. Lieberman HR, Coffey BP, Kobrick J. A vigilance task sensitive to the
Hampshire A, Zelaya FO, O'Gorman RL, McMorris T, Owen AM,
effects of stimulants, hypnotics and environmental stress-the scanning
et al. Dehydration affects brain structure and function in healthy
visual vigilance test. Behav Res Methods Instrum Comput. 1998;
adolescents. Hum Brain Mapp. 2011;32:71–9.
27. Di S, Tasker JG. Dehydration-induced synaptic plasticity in magnocel-
16. Dinges DF, Powell JW. Microcomputer analyses of performance on a
lular neurons of the hypothalamic supraoptic nucleus. Endocrinology.
portable, simple, visual RT task during sustained operations. Behav Res
Methods Instrum Comput. 1985;17:652–5.
28. Armstrong LE. Assessing hydration status: the elusive gold standard. J
17. Lieberman HR, Tharion WJ, Shukitt-Hale B, Speckman KL, Tulley R.
Am Coll Nutr. 2007;26:S575–84.
Effects of caffeine, sleep loss, and stress on cognitive performance and
29. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ,
mood during U.S. Navy SEAL training. Sea-Air-Land. Psychopharma-
Stachenfeld NS. American College of Sports Medicine position stand.
cology (Berl). 2002;164:250–61.
Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39:377–90.
18. Banderet LE, Lieberman HR. Treatment with tyrosine, a neurotrans-
30. May RR. Mood shifts and the menstrual cycle. J Psychosom Res.
mitter precursor, reduces environmental stress in humans. Brain Res
31. Stachenfeld NS, DiPietro L, Kokoszka CA, Silva C, Keefe DL, Nadel
19. Shukitt-Hale B, Askew EW, Lieberman HR. Effects of 30 days of
ER. Physiological variability of fluid-regulation hormones in young
undernutrition on reaction time, moods, and symptoms. Physiol Behav.
women. J Appl Physiol. 1999;86:1092–6.
32. Rosenfeld R, Livne D, Nevo O, Dayan L, Milloul V, Lavi S, Jacob G.
20. Lieberman HR, Bathalon GP, Falco CM, Georgelis JH, Morgan CA III,
Hormonal and volume dysregulation in women with premenstrual
Niro P, Tharion WJ. The "fog of war": documenting cognitive
syndrome. Hypertension. 2008;51:1225–30.
decrements associated with combat-like stress. Aviation, Space, Envi-ronmental Medicine. 2005;76:C7–14.
33. D'Anci KE, Constant F, Rosenberg IH. Hydration and cognitive
function in children. Nutr Rev. 2006;64:457–64.
21. Baddeley AD. A 3 min reasoning test based on grammatical transfor-
mation. Psychon Sci. 1968;10:341–2.
34. Stoner GD. Hyperosmolar hyperglycemic state. Am Fam Physician.
22. McNair DM, Lorr M, Droppelman LF. Manual for the profile of mood
states. San Diego: Educational and Industrial Testing Service; 1971.
35. Wotton K, Crannitch K, Munt R. Prevalence, risk factors and strategies
23. Lieberman HR, Falco CM, Slade SS. Carbohydrate administration
to prevent dehydration in older adults. Contemp Nurse. 2008;31:44–
during a day of sustained aerobic activity improves vigilance, as assessed
by a novel ambulatory monitoring device, and mood. Am J Clin Nutr.
36. Shirreffs SM. Markers of hydration status. Eur J Clin Nutr. 2003;57
Suppl 2:S6–9.
24. Armstrong LE, Kenefick RW, Castellani JW, Riebe D, Kavouras SA,
37. Hancock PA, Vasmatzidis I. Effects of heat stress on cognitive
Kuznicki JT, Maresh CM. Bioimpedance spectroscopy technique: intra-,
performance: the current state of knowledge. Int J Hyperthermia.
extracellular, and total body water. Med Sci Sports Exerc. 1997;
38. Rodriguez GJ, Cordina SM, Vazquez G, Suri MF, Kirmani JF, Ezzeddine
25. Ganio MS, Armstrong LE, Casa DJ, McDermott BP, Lee EC, Yamamoto
MA, Qureshi AI. The hydration influence on the risk of stroke
LM, Marzano S, Lopez RM, Jimenez L, Le Bellego L, et al. Mild
(THIRST) study. Neurocrit Care. 2009;10:187–94.
Mild dehydration, mood, and cognitive performance
Source: http://cepea.com.ar/cepea/wp-content/uploads/2013/08/Mild-Dehydration-Affects-Mood-in-Healthy.pdf
& the Authority of Christ by Russell D. Moore Counseling and the Authority of Christ: A New Vision for Biblical Counseling at The Southern Baptist Theological Seminary "And they were astonished at His teaching, for He taught them as one having authority, and not as the scribes." [Mark 1:22 ESV] The story of The Southern Baptist Theological Seminary is seen most clearly not in
Physiology of Hormones by Dr. Sherrill Sellman Women and hormones equal big business these days. Like animals lured into a snare by a trail of crumbs, women have been cajoled with scientific studies, media advertising, patient handbooks and drug samples to accept Hormone Replacement Therapy as a magic potion. HRT is praised as the cure for hot flashes and all the other symptoms assigned to the menopause pantheon. In