ReviewNutrients2025
Hydration Strategies in Ultra-Endurance Running: A Narrative Review of Programmed Versus Thirst-Driven Approaches.
Review in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Day-to-day variability and method agreement of sweat sodium concentration during pilocarpine iontophoresis and exercise.European journal of applied physiology · 2026Article
- 24-Hour Ultra-Marathon Running: A Narrative Review of Performance Factors and Physiological Impacts.Sports medicine - open · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesUltra-endurance running (UER) presents unique hydration challenges due to prolonged duration, variable terrain, environmental extremes, and gastrointestinal limitations. Athletes often use either programmed fluid intake (PFI), which prescribes fluid volumes based on estimated sweat rate, or thirst-driven fluid intake (TDFI), which relies on internal cues. This review examines the effectiveness and limitations of each strategy in the context of UER performance and safety.
methodsA narrative review was conducted using a targeted selection of peer-reviewed studies. Both laboratory- and field-based research were included to evaluate the physiological rationale, practical feasibility, and outcomes associated with PFI and TDFI. A total of six studies (five field-based ultra-endurance and one laboratory-based endurance protocols) were included for narrative synthesis.
resultsLaboratory trials support PFI for preserving plasma volume, reducing cardiovascular strain, and improving performance in prolonged exercise under controlled conditions. However, real-world ultra-endurance events often involve environmental and logistical challenges that limit the applicability of rigid hydration strategies. Field studies demonstrate that TDFI is safe and effective for many experienced athletes, with no increased incidence of exercise-associated hyponatremia or measurable performance impairment, even with moderate body mass loss. Still, TDFI may underperform in individuals with high sweat rates or impaired thirst perception.
conclusionsNeither strategy seems universally superior. A hybrid model that integrates individual sweat testing, environmental context, and responsiveness to internal cues may offer the most practical and effective hydration approach in ultra-endurance running. Continued research is needed to validate hydration strategies under field conditions and to inform personalized, performance-oriented guidelines.
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Registered trials
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