Caffeine as a Diuretic
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In response to a recent discussion:
Int J Sport Nutr Exerc Metab. 2002 Jun;12(2):189-206 Caffeine, body fluid-electrolyte balance, and exercise performance. Armstrong LE. Departments of Kinesiology, Nutritional Sciences, and Physiology & Neurobiology, University of Connecticut, Storrs, CT 06269-1110, USA. Recreational enthusiasts and athletes often are advised to abstain from consuming caffeinated beverages (CB). The dual purposes of this review are to (a) critique controlled investigations regarding the effects of caffeine on dehydration and exercise performance, and (B) ascertain whether abstaining from CB is scientifically and physiologically justifiable. The literature indicates that caffeine consumption stimulates a mild diuresis similar to water, but there is no evidence of a fluid-electrolyte imbalance that is detrimental to exercise performance or health. Investigations comparing caffeine (100-680 mg) to water or placebo seldom found a statistical difference in urine volume. In the 10 studies reviewed, consumption of a CB resulted in 0-84% retention of the initial volume ingested, whereas consumption of water resulted in 0-81% retention. Further, tolerance to caffeine reduces the likelihood that a detrimental fluid-electrolyte imbalance will occur. The scientific literature suggests that athletes and recreational enthusiasts will not incur detrimental fluid-electrolyte imbalances if they consume CB in moderation and eat a typical U.S. diet. Sedentary members of the general public should be a less risk than athletes because their fluid losses via sweating are smaller. PMID: 12187618
Exerc Sport Sci Rev. 2007 Jul;35(3):135-40. Caffeine, fluid-electrolyte balance, temperature regulation, and exercise-heat tolerance. Armstrong LE, Casa DJ, Maresh CM, Ganio MS. Department of Kinesiology, Human Performance Laboratory, University of Connecticut, CT 06269-1110, USA. [email protected] Dietitians, exercise physiologists, athletic trainers, and other sports medicine personnel commonly recommend that exercising adults and athletes refrain from caffeine use because it is a diuretic, and it may exacerbate dehydration and hyperthermia. This review, contrary to popular beliefs, proposes that caffeine consumption does not result in the following: (a) water-electrolyte imbalances or hyperthermia and (b) reduced exercise-heat tolerance. PMID: 17620932
Can J Physiol Pharmacol. 1990 Jul;68(7):889-92. Effects of caffeine ingestion on body fluid balance and thermoregulation during exercise. Falk B, Burstein R, Rosenblum J, Shapiro Y, Zylber-Katz E, Bashan N. Faculty of Health Sciences, McMaster University, Hamilton, Ont., Canada. This study investigated the effects of caffeine supplementation on thermoregulation and body fluid balance during prolonged exercise in a thermoneutral environment (25 degrees C, 50% RH). Seven trained male subjects exercised on a treadmill at an intensity of 70-75% of maximal oxygen consumption to self-determined exhaustion. Subjects exercised once after caffeine and once after placebo ingestion, given in a double-blind crossover design. Five milligrams per kilogram body weight of caffeine followed by 2.5 mg.kg-1 of caffeine were given 2 and 0.5 h before exercise, respectively. Rectal temperature was recorded and venous blood samples were withdrawn every 15 min. Water loss and sweat rate were calculated from the difference between pre- and post-exercise body weight, corrected for liquid intake. Following caffeine ingestion, when compared with placebo, no significant difference in final temperature or in percent change in plasma volume were found. No significant differences were observed in total water loss (1376 +/- 154 vs. 1141 +/- 158 mL, respectively), sweat rate (12.4 +/- 1.1 vs. 10.9 +/- 0.7 g.m-2.min-1, respectively), rise in rectal temperature (2.1 +/- 0.3 vs. 1.5 +/- 0.4 degrees C, respectively), nor in the calculated rate of heat storage during exercise (134.4 +/- 17.7 vs. 93.5 +/- 22.5 W, respectively). Thus, in spite of the expected rise in oxygen uptake, caffeine ingestion under the conditions of this study does not seem to disturb body fluid balance or affect thermoregulation during exercise performance. PMID: 2383801
Diuretic potential of energy drinks. Riesenhuber A, Boehm M, Posch M, Aufricht C. Department of Pediatrics, Medical University of Vienna, Vienna, Austria. Recent literature suggests that both caffeine and taurine can induce diuresis and natriuresis in rat and man. Although they act via different cellular mechanisms, their diuretic actions might be additive. This is of considerable interest, as several commercially available energy drinks contain both substances. In this study we examined the possible diuretic effects of caffeine and taurine in a cross-over-design in which 12 healthy male volunteers received each of 4 different test drinks (750 ml of energy drink containing 240 mg caffeine and 3 g taurine, the three other test drinks either lacked caffeine, taurine or both) after restraining from fluids for 12 h. Mixed model analyses demonstrated that urinary output and natriuresis were significantly increased by caffeine (mean differences 243 ml and 27 mmol; both p < 0.001) and that there were no such effects of taurine (mean differences 59 ml and -4 mmol). Additionally, urinary osmolarity at baseline was significantly related to the urinary output (p < 0.001). Urine osmolarity values at baseline and in the 6 h urine collection did not differ significantly between treatments. Taken together, our study demonstrates that diuretic and natriuretic effects of the tested energy drink were largely mediated by caffeine. Taurine played no significant role in the fluid balance in moderately dehydrated healthy young consumers. Consequently, the diuretic potential of energy drinks will not differ significantly from other caffeine containing beverages. PMID: 16847703 [PubMed — indexed for MEDLINE]
It’s unclear whether these results should be taken as applicable to “normal situations,” or simply to suggest that caffeinated beverages are not ideal for rehydration from a dehydrated state. From the FT:
In our experimental system, moderate dehydration was induced in the young healthy participants by a 12 h thirst period. As expected, this pretreatment not only resulted in a standardized ‘‘dry’’ volume status of the participants (urine osmolarity higher than 800mosm=l), but also in- duced a significant stimulus for fluid retention. As a con- sequence, differential diuretic effects should have become particularly evident under these conditions. Indeed, na- triuretic effects of caffeine were readily detectable. How- ever, neither diuresis, natriuresis nor urinary osmolarity were affected by taurine.
The effect of drinking tea at high altitude on hydration status and mood. Scott D, Rycroft JA, Aspen J, Chapman C, Brown B. Colworth House, Unilever R&D Colworth, Sharnbrook, Bedford MK44 1LQ, UK. [email protected] The effect of drinking tea on hydration status and mood was studied in nine male and four female members of expeditions based at Mt. Everest base camp at an altitude of 5,345 m. Whilst exposed to altitude-cold diuresis, participants were subjected to a crossover experimental design comprising two 24-h dietary interventions. In the “tea” condition, hot brewed tea formed a major part of fluid intake, whereas in the “no-tea” condition tea was excluded from the diet. Subjects were prohibited in both cases from consuming other caffeinated beverages, caffeinated foods, and alcoholic drinks. Mean fluids ingested [mean (SE); tea=3,193 (259) ml versus no tea=3,108 (269) ml] and urine volume (tea=2,686 (276) ml versus no tea=2,625 (342) ml] were similar under both conditions. Statistical analysis found no difference in urine stimulated as a result of the tea intervention (P=0.81). Several markers of hydration status were also taken immediately pre and post each condition, including measures of urine specific gravity, urine electrolyte balance (K+, Na+), and urine colour. None of these measures indicated a difference in hydration status as a result of the dietary intervention in either the control or tea condition. A difference was, however, found in mood, with subjects reporting reduced fatigue when tea was included in the diet (P=0.005). The study shows therefore that even when drunk at high altitude where fluid balance is stressed, there is no evidence that tea acts as a diuretic when consumed through natural routes of ingestion by regular tea drinkers, but that it does have a positive effect on mood. PMID: 14872247 [PubMed — indexed for MEDLINE] J Am Coll Nutr. 2000 Oct;19(5):591-600. The effect of caffeinated, non-caffeinated, caloric and non-caloric beverages on hydration. Grandjean AC, Reimers KJ, Bannick KE, Haven MC. The Center for Human Nutrition, Omaha 68105, USA. [email protected] OBJECTIVE: To examine the effect of various combinations of beverages on hydration status in healthy free-living adult males. METHODS: In a counterbalanced, crossover manner, 18 healthy adult males ages 24 to 39, on four separate occasions, consumed water or water plus varying combinations of beverages. Clinical guidelines were used to determine the fluid allowance for each subject. The beverages were carbonated, caffeinated caloric and non-caloric colas and coffee. Ten of the 18 subjects consumed water and carbonated, non-caffeinated, citrus soft drink during a fifth trial. Body weight, urine and blood assays were measured before and after each treatment. RESULTS: Slight body weight loss was observed on all treatments, with an average of 0.30% for all treatments. No differences (p>0.05) among treatments were found for body weight changes or any of the biochemical assays. Biochemical assays conducted on first voids and 24-hour urines included electrolytes, creatine, osmolality and specific gravity. Blood samples were analyzed for hemoglobin, hematocrit. electrolytes, osmolality, urea nitrogen, creatinine and protein. CONCLUSIONS: This preliminary study found no significant differences in the effect of various combinations of beverages on hydration status of healthy adult males. Advising people to disregard caffeinated beverages as part of the daily fluid intake is not substantiated by the results of this study. The across-treatment weight loss observed, when combined with data on fluid-disease relationships, suggests that optimal fluid intake may be higher than common recommendations. Further research is needed to confirm these results and to explore optimal fluid intake for healthy individuals. PMID: 11022872 Full text [url=”http://www.jacn.org/cgi/content/full/19/5/591”]here[/url].
J Hum Nutr Diet. 2003 Dec;16(6):411-20. Caffeine ingestion and fluid balance: a review. Maughan RJ, Griffin J. School of Sport and Exercise Sciences, Loughborough University, Leicestershire, UK. [email protected] BACKGROUND: Caffeine and related methylxanthine compounds are recognized as having a diuretic action, and consumers are often advised to avoid beverages containing these compounds in situations where fluid balance may be compromised. The aim of this review is to evaluate the available literature concerning the effect of caffeine ingestion on fluid balance and to formulate targeted and evidence-based advice on caffeinated beverages in the context of optimum hydration. METHOD: A literature search was performed using the Medline database of articles published in the medical and scientific literature for the period of January 1966-March 2002. Subject headings and key words used in this search were: tea, coffee, caffeine, diuresis, fluid balance and water-electrolyte balance. A secondary search was performed using the bibliographies of publications identified in the initial search. RESULTS: The available literature suggests that acute ingestion of caffeine in large doses (at least 250-300 mg, equivalent to the amount found in 2-3 cups of coffee or 5-8 cups of tea) results in a short-term stimulation of urine output in individuals who have been deprived of caffeine for a period of days or weeks. A profound tolerance to the diuretic and other effects of caffeine develops, however, and the actions are much diminished in individuals who regularly consume tea or coffee. Doses of caffeine equivalent to the amount normally found in standard servings of tea, coffee and carbonated soft drinks appear to have no diuretic action. CONCLUSION: The most ecologically valid of the published studies offers no support for the suggestion that consumption of caffeine-containing beverages as part of a normal lifestyle leads to fluid loss in excess of the volume ingested or is associated with poor hydration status. Therefore, there would appear to be no clear basis for refraining from caffeine containing drinks in situations where fluid balance might be compromised. PMID: 19774754 [PubMed — in process]
Update Oct 13, 2013: Found a new one:
Appl Physiol Nutr Metab. 2013 Jun;38(6):626-32. doi: 10.1139/apnm-2012-0253. Epub 2013 Jan 15. Total body water and its compartments are not affected by ingesting a moderate dose of caffeine in healthy young adult males. Silva AM, Júdice PB, Matias CN, Santos DA, Magalhães JP, St-Onge MP, Gonçalves EM, Armada-da-Silva P, Sardinha LB. Source a Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Tecn Lisboa, Cruz-Quebrada 1499-002, Portugal. Abstract: Acute and chronic caffeine intakes have no impact on hydration status (R.J. Maughan and J. Griffin, J. Hum. Nutr. Diet. 16(6): 411-420, 2003), although no research has been conducted to analyze the effects using dilution techniques on total-body water (TBW) and its compartments. Therefore, the aim of this study was to investigate the effects of a moderate dose of caffeine on TBW, extracellular water (ECW), and intracellular water (ICW) during a 4-da
y period in active males. Thirty men, nonsmokers and low caffeine users (<100 mg·day(-1)), aged 20-39 years, participated in this double-blind, randomized, crossover trial (ClinicalTrials.gov: No. NCT01477294). The study included 2 conditions (5 mg·kg(-1)·day(-1) of caffeine and placebo (malt-dextrin)) of 4 days each, with a 3-day washout period. TBW and ECW were assessed by deuterium oxide and sodium bromide dilution, respectively, whereas ICW was calculated as TBW minus ECW. Body composition was assessed by dual-energy X-ray absorptiometry. Physical activity (PA) was assessed by accelerometry and water intake was assessed by dietary records. Repeated-measures analysis of variance (ANOVA) was used to test main effects. No changes in TBW, ECW, or ICW and no interaction between the randomly assigned order of treatment and time were observed (p > 0.05). TBW, ECW, and ICW were unrelated to fat-free mass, water ingestion, and PA (p > 0.05). These findings indicate that a moderate caffeine dose, equivalent to approximately 5 espresso cups of coffee or 7 servings of tea, does not alter TBW and fluid distribution in healthy men, regardless of body composition, PA, or daily water ingestion. PMID: 23724879 [PubMed — in process]