Newbury Victoria Kin355 Discussion Section 4 Date Submitted 9 22 13 Research Paper Assignment 1 Notes Section 1 Notes on The intravenous use of coconut water Campbell Falck Thomas Falck Tutuo Clem 2000 Campbell Falck et al 2000 o Remote Regions of the world Solomon island patient case study o Shortages in medical resources Needed for intravenous hydration Intravenous existing or taking place within or administered into a vein or veins Needed for resuscitation Physicians sometimes have to do without o Coconut water used for short term as a replacement Lab analysis done of local coconuts Documented intravenous coconut use Table 1 Composition of Coconut water Conclusion o Case study Coconut water was administered intravenously No adverse effects o Coconut fluid Effective form of intravenous hydration solution Small volumes Short periods of time Temporizing alternative where supplies are scarce Coconuts are abundant and inexpensive Good source of nutrition Potassium Chloride Calcium Future Used when specific electrolytes are needed to be urgently increased Further studies need to be done to substantiate emergency use as a rehydration solution 2 Notes on Comparison of coconut water and a carbohydrate electrolyte sport drink on measures of hydration and physical performance in exercise trained men Kalman Feldman Krieger Bloomer 2012 I Kalaman et al 2012 I o Background Sports drinks Ubiquitous present appearing or found everywhere Artificially flavored In recreational competitive fitness Manufactured Coconut water Gaining attention Natural Indicating efficacy in maintaining hydration Compared the two Physical performance Hydration o Methods 60 min treadmill Dehydrating 12 exercise trained men 26 6 5 7 years Drank Water Pure coconut water vitacoco Coconut water from concentrate Carb electrolyte sport drink Amount determined by body mass loss during exercise 4 occasions separated by 5 days each Random order Single blind subjects Cross over design Hydration status measurement Body mass Fluid retention Plasma osmolality Urine specific gravity Performance status measurement Treadmill time to exhaustion Assessed after rehydration Both measured during recovery period Subjective measures Thirst Bloated ness Refreshed Stomach upset Tiredness 5 point visual analog scale o Results Lost 1 7 kg 2 body mass during exercise Regained it by consumption of all conditions No differences in the natural vs from concentrate coconut water or sports drink for fluid retention No differences in difference in exercise performance Subjects more bloated greater stomach upset with both coconut waters o Conclusion All capable of rehydration and supporting exercise Little difference in markers of hydration and exercise performance Additional study More demanding dehydration protocol Time trial tests as a measure of exercise performance o Specifically determine efficacy of enhancing hydration and performance 3 Notes on Rehydration after exercise with fresh young coconut water carbohydrate electrolyte beverage and plain water Saat Singh Sirisinghe Nawawi 2002 I Saat et al 2002 o Cross over study Effectiveness of Fresh young coconut water Carb electrolyte beverage Plain water For whole body rehydration blood volume restoration 2 hour rehydration period After exercise induced dehydration o Subjects 8 healthy male volunteers Age 22 4 3 3 Have similar Vo2max scores o Methods Exercise at 60 of Vo2max in the heat Lose about 3 of their body weight Afterwards Sit for 2 h rehydration period Thermo neutral environment o Thermo neutral describing an environment in or out of which heat is not transferred Drank a volume of water coco water carb electro beverage 120 fluid loss o Consumed in 3 portions 30 mins apart o 50 40 30 o Drinks given randomized Blood urine sample Body weight before and after and at 30 min intervals o Results during rehydration period Some hypo hydrated o Hypo hydrated excessive loss of body fluid o Urine sweat metabolism respiration Body weight regained not dif for each trial Rehydration index body weight restoration not very different Blood volume better for coco water not statistically different from the other 2 beverages though No dif in sodium or chloride serum osmolality or net fluid balance between 3 trials Plasma glucose levels highest with plain water Urine osmolality lowest with water Coco water o Sweeter o Less nausea o Fullness o No stomach upset o Easier to consume in large amount o Can be used for whole body rehydration after exercise Conclusion o Stated in abstract notes o Further investigation Test effectiveness on whole body rehydration after exerciseinduced dehydration by increasing sodium content of coconut water equivalent to a recommended sports drink 4 Notes on dehydration Vorwick Zieve 2011 Body doesn t have as much water and fluids as it should Can be mild moderate severe based on how much is lost or not replenished Severe can be life threatening Causes incidences and risk factors o Cause Lose too much fluid Excessive sweating Excessive urine output Fever Vomiting Diarrhea Not drinking enough water fluids both Loss of appetite illness Nausea Sore throat Mouth sores Symptoms o Dry sticky mouth o Lethargy coma severe o Low urine output none o No tears o Sunken eyes o Sunken fontanelles of infant soft spot on head Signs and tests o Blood pressure drops when you go lying standing o Delayed capillary refill o Low bp o Poor skin turgor o Rapid hr o Shock o Tests Blood chemistries Electrolytes Sodium Potassium Bicarbonate levels Blood urea nitrogen BUN Complete blood count Creatinine Urine specific gravity Treatment o Drinking fluids Often don t force large amounts brings on vomit Electrolyte solutions Freezer pops Sports drinks bad lots of sugar Worsen diarrhea Intravenous fluids Expectations prognosis o When found quickly treated outcome is good Complications o Death o Permanent brain damage o Seizures Call for help if o Blood in stool vomit o Diarrhea in infants less then 2 months o Dry mouth eyes o Dry skin o Fast hr o Listlessness inactiveness o No urine output 8 hours o No tears Prevention o Drink plenty of fluids everyday o Drink more when its hot you re exercising o Monitor people who are ill Encourage them to drink fluids 5 Notes on Water hydration and health Popkin D Anci Rosenberg 2010 I Popkin et al 2010 I Abstract o Intake patterns o Mechanisms behind homeostasis o Variation in intake Energy Weight Performance Functioning Introduction o Regulation of fluid intake Essential for