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Fluid Balance, Hydration, and Athletic Performance

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Athletes and nonathletes frequently consume too little water or fluids, affecting exercise performance as well as overall health. This book comprehensively reviews the aspects relating to body fluid balance, rehydration, and physical exercise. It provides background on body water balance and turnover, topics related to
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2016 by CRC Press
Reference - 437 Pages - 39 B/W Illustrations
ISBN 9781482223286 - CAT# K22323
Flavia Meyer
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Zbigniew Szygula
University of Physical Education in Kraków, Poland
Boguslaw Wilk
McMaster Children s Hospital and McMaster University, Hamilton, Ontario, Canada
Athletes and nonathletes frequently consume too little water or fluids, affecting
exercise performance as well as overall health. This book comprehensively reviews
the aspects relating to body fluid balance, rehydration, and physical exercise. It
provides background on body water balance and turnover, topics related to
electrolyte balance, and sweating as the basis for thermoregulatory and fluid
homeostasis during exercise. In addition, chapters cover body water balance
evaluation and regulation; cardiovascular and metabolic responses to fluid
imbalance; effects of dehydration on aerobic power, muscle strength, and cognitive
function; fluid intake timing; and optimal beverage selection.
SELECTED CONTENTS
The Fundamentals of Body Fluid Balance. Effects of Fluid Imbalance on Body
Functions and Performance. Special Populations. Recommendations.
Features
Offers comprehensive review of basic aspects relating to body fluid balance and rehydration
in sport and physical exercise
Considers special groups of athletes with chronic health conditions
Includes recent and specific recommendations on fluid replenishment
Updates controversial fluid intake-related issues
Features contributions from experts within respective research and/or clinical areas
Provides text suitable for a wide range of academic, health professionals, and athletes
needs
Summary
Fluid Balance, Hydration, and Athletic Performance presents a comprehensive review of
aspects relating to body fluid balance, rehydration, sport, and physical exercise. The content is
scientifically supported, practical, and suitably written for a range of audiences, including
academics (professors and students) and sports and health professionals (coaches, physical
educators, nutritionists, and physicians), as well as athletes and individuals involved in physical
activities.
Compared to other books previously published in this area, this book does not limit body
hydration issues to the average or elite adult athlete. Rather, it addresses aspects relevant to a
range of individuals of different ages (adolescents and master athletes) competing in various
sports. In recognition of the growing number of individuals with specific medical conditions who
have been exercising more and even participating in competitive sports, separate chapters on
prevalent diseases or medical conditions associated with risks of body fluid homeostasis also are
presented.
To achieve such a complete and qualified publication, the book is written by top experts and
professionals experienced in their respective research areas. It presents the basics of fluid
balance and provides updates on controversial fluid intake-related issues such as hyponatremia,
optimal recovery, intermittent sports, and perceptual responses.
Table of Contents
THE FUNDAMENTALS OF BODY FLUID BALANCE
Body Water: Balance, Turnover, Regulation, and Evaluation
Sodium Balance during Exercise and Hyponatremia
Human Perspiration and Cutaneous Circulation
EFFECTS OF FLUID IMBALANCE ON BODY FUNCTIONS AND PERFORMANCE
Cardiovascular Responses to Body Fluid Imbalance
Thermal Strain and Exertional Heat Illness Risk: Total Body Water and Exchangeable Sodium
Deficits
Gastrointestinal and Metabolic Responses to Body Fluid Imbalance during Exercise
Role of Fluid Intake in Endurance Sports
Effect of Dehydration on Muscle Strength, Power, and Performance in Intermittent High-Intensity
Sports
Effect of Dehydration on Cognitive Function, Perceptual Responses, and Mood
SPECIAL POPULATIONS
Dehydration and the Young Athlete: Effects on Health and Performance
Water Balance and Master Athletes
Athletes with Chronic Conditions: Diabetes
Athletes with Chronic Conditions: Obesity
Athletes with Chronic Conditions: Hypertension
Athletes with Chronic Renal Diseases
Practical Considerations for Fluid Replacement for Athletes with a Spinal Cord Injury
Athletes with Chronic Conditions: Sickle Cell Trait
RECOMMENDATIONS
Water Replacement before, during, and after Exercise: How Much Is Enough?
Plain Water or Carbohydrate-Electrolyte Beverages
Need of Other Elements
... In addition, studies recommend fluid intake such as water intake, sports drink intake, etc. in terms of general health and performance decline. The purpose of fluid intake is to prevent the performance-impairing effects of hypohydration by replacing the fluid lost during exercise with preferred beverages in specified periods and to increase performance [1][2][3]. In this process, water intake creates a stabilizing effect, but it is less preferred by athletes due to its tastelessness. ...
... In this process, water intake creates a stabilizing effect, but it is less preferred by athletes due to its tastelessness. Flavored sports drinks prepared with carbohydrates and electrolytes are preferable [1]. When the relationship between shooting accuracy and fluid intake is considered, water intake maintains shooting accuracy and even provides low-level (3-4%) increases [9]. ...
... Inadequate fluid intake or fluid restriction processes lead to core temperature values rising to~40 • C in athletes [1]. Increased core temperature causes physiological stress and a gradual decrease in body water through sweating rate. ...
Article
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(1) Background: This study aimed to investigate the effects of fluid restriction and intake (water vs. sports drink) on shooting accuracy and speed in adolescent handball players, a population with high sensitivity to hydration levels yet understudied in this context. (2) Methods: A total of 47 adolescent competitive handball players (15.04 ± 1.5 years) were included in this study, and the participants were divided into low, average, and high performance according to their shooting performance in the familiarization session. All participants were exposed to fluid restriction and intake conditions during handball training on different days. Before and after the training sessions, changes in shooting accuracy and speed were evaluated. (3) Results: The training protocol resulted in body mass loss in the Average Performer group (p = 0.001). Compared to fluid restriction, fluid intake (water intake and sports drink intake) post-training had a positive main effect on shooting accuracy, F(2, 88) = 34.32, p < 0.001, ηp² = 0.44, and shooting speed, F(1, 61) = 4.05, p = 0.35, ηp² = 0.84. (4) Conclusions: Hydration level plays an important role in shooting accuracy and speed performance in adolescent handball players. Therefore, fluid intake integrated into training or match sessions may contribute to the maintenance and improvement of shooting performance.
... Water is of great importance for human life. It plays an important role in all biochemical reactions that occur within the body and is a must for preserving blood volume (Meyer, Szygula, & Wilk, 2016). Considering that water has a role in physiological functions, it is not surprising that it also has an important role in maintaining exercise performance. ...
... It presents negative consequences for athletes. Dehydration is associated with a decrease in serum sodium levels and stroke volume, an increase in core body temperature, cardiac output, plasma fluid losses and hemoconcentration (Meyer et al., 2016). In addition, González-Alonso, Mora-Rodriguez, Below, and Coyle (1997) stated that dehydration yields adverse effects on cardiovascular functioning. ...
... Given that judo is a very popular sport in the world and because judo competitions are carried out throughout the year, athletes are doomed to apply rapid weight loss beginning with very early age (i.e. 12.5 ± 2.2) (Berkovich, Eliakim, Nemet, Stark, & Sinai, 2016) and thus exposed to dehydration (Gurses, Ceylan, Akgul, & Baydil, 2018) and acute dehydration means health-related problems and injuries for most of the athletes (Meyer et al., 2016). ...
Article
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Despite numerous studies related to dehydration there is still a lack of scientific literature presenting hydration status and fluid intake of judo athletes during different periods. Therefore, the aim of this study was to investigate, fluid intake, hydration status and body weight changes of young judo athletes during a typical day of training in preparation period. Twenty-two young judo athletes (age: 12 ± 0.7 y, experience: 3.5 ± 1.1) voluntarily participated in this study. Hydration status and weight were examined in the morning, before and immediately after the training. All athletes trained 90 min and they consumed fluids ad libitum during the exercise. According to morning urine specific gravity (USG) values, 81.2% of the athletes were dehydrated while only 18.8% of the athletes were euhydrated. Pre-training urine measurements showed that 63.64% of the athletes presented dehydration and 77.27% of the athletes completed the training in dehydrated condition despite fluid availability during the training. Mean body weight loss during training was-0.64 ± 0.66%. It can be concluded that young judo athletes presented high prevalence of dehydration as indicated by USG values. Most of the athletes were dehydrated during a typical training day and completed the training in more dehydrated conditions compared to pre training values despite ad libitum fluid intake. It is of great importance to evaluate hydration status of the athletes before training to refrain from common practice of fluid restriction for weight loss and adverse effects of a persistent state of fluid deficit on physical and health related state.
... Excess fluid excretion that is not balanced with adequate water intake can cause dehydration. Dehydration in athletes can cause a decrease in the performance of muscle strength, muscle endurance, and muscle power and can even interfere with cognitive function (Magee et al., 2017;Meyer et al., 2016). ...
... Good hydration conditions in athletes are very important because if there is a decrease in hydration status, it will interfere with the physiological work of the muscles. The results of other studies show that hypohydration or dehydration conditions in athletes show a decrease in muscle performance such as muscle strength, muscle endurance, and muscle power (Goulet et al., 2018;Judelson et al., 2007;Magee et al., 2017;Meyer et al., 2016;Savoie et al., 2015). Also, hypohydration has been shown to cause decreased blood flow and changes in skeletal muscle metabolism (increased lactate, muscle glycogenolysis, and carbohydrate oxidation) (Nuccio et al., 2017). ...
... A decrease of 3%-4% of the total water in the body can reduce muscle strength by about 2% (Meyer et al., 2016). A decrease of 3% -4% of body mass can decrease the explosive power of muscles by about 3% -endurance performance, especially in hot weather (Magee et al., 2017). ...
Article
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Water is a molecule that plays an essential role in the muscle contraction process because muscle is a tissue that mostly contains water (75-80%). Therefore, athletes need to maintain fluid intake to support their physical activities when competing and when training. Nevertheless, in several studies, it was noted that some athletes experienced hypohydration or dehydration, which ultimately impaired muscle performance. Therefore, this study was conducted to determine the hydration protocol intervention on muscle strength, endurance, and power performance. This research is an analytical study with quasi-experimental research methods, namely single-arm pre-post study design using secondary data. Subjects of this study were 69 athletes year 2020 (named consecutively: Muaythai 9, Pencak silat 12, wrestling 10, judo 18, and taekwondo 20 athletes). This research was conducted from December 2019 to January 2020. In the beginning, all athletes were tested for muscle strength using a leg dynamometer, then muscle endurance tests using push-up and sit-up tests, and muscle power tests using the triple hop test of the right and left legs. After the first test, all athletes were educated about the hydration protocol. The hydration protocol was determined based on each athlete's sweat rate (ISR) and the training characteristics of each sports division. Then, all athletes underwent the training for two months. After that, the same tests were performed. The result showed that hydration protocol influenced the performance of muscle strength, endurance, and power. Therefore, the hydration protocol is influential in maintaining a good hydration status in athletes so that the athlete does not experience hypohydration which will later impair the athlete's muscle performance. Therefore, it is crucial to apply hydration protocols individually according to the training program (volume of training), not only in martial arts sports but in all sports.
... Firefighters who work in higher altitudes also lose more respiratory fluid. Figure 1 demonstrates areas of fluid loss, with respiratory and sweat fluid loss being the most variable [78][79][80]. ...
... Firefighters who work in higher altitudes also lose more respiratory fluid. Figure 1 demonstrates areas of fluid loss, with respiratory and sweat fluid loss being the most variable [78][79][80]. Identifying fluid losses helps determine an appropriate rehydration strategy. In the acute setting, rehydration with a volume greater than the volume lost is recommended due to the expected volume loss to urine and sweat production in the recovery period. ...
Article
Full-text available
Background/Objectives: Firefighters are exposed to a high level of stress as they often perform physically challenging work in hazardous environments while responsible for rescuing and keeping those around them safe. To add to this stress, they are also required to work in heavy, unbreathable personal protective equipment which promotes dehydration. These occupational demands paired with dehydration may lead to increased core temperatures, cardiac strain, and overall risk for sudden cardiac events. Thus, it is important to include hydration assessments and determine fluid needs when firefighters are on shift to ensure their personal safety as well as the safety of those around them by optimizing physical performance by maintaining adequate hydration. Therefore, the purpose of this review is to identify markers of hydration, classifications of hydration status, current hydration recommendations, and hydration interventions that may contribute to the overall clarity of hydration protocols that may optimize performance and health of firefighters. In addition, the impact of common medications, exercise training, and health conditions on hydration status related to firefighters will be discussed. Methods: A comprehensive literature search was conducted to discuss the purpose statements. Results: Hydration recommendations for firefighters include (1) assessing hydration status with multiple measurements including body mass, urine specific gravity and thirst sensation, and (2) following general hydration recommendations on rest days and exercise hydration protocols during firefighting activities which may be altered according to hydration status measurements. Conclusion: Randomized controlled trials in firefighters are needed to determine the impact of maintaining adequate hydration on health markers.
... Previous studies have shown that some of the most frequently used methods for RWL are the fluid restriction or dehydration strategies, such as using sauna and plastic clothing [5]; or more aggressive methods, such as diuretics and laxatives [6]. It is known that dehydration may lead to a decrease in athletic skill and motor function to a great extent [7][8][9], increased heart rate due to the effort [10], renal impairment in severe cases [11], and adverse effects on neuromuscular and cognitive systems [12,13]. ...
... Dehydration may affect neural, cognitive, and metabolic responses in one, some, or all components [12]. For example, more significant dehydration decreased athletic skill and motor function to a great extent [7,8]. ...
Article
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Background: The present study investigated highly trained male judo athletes and how a 5% body mass dehydration affects their judo-specific performance and physiological responses. Methods: Nine highly trained international-level male judo athletes who are weight-cyclers voluntarily participated in the study. The study had a controlled crossover design in nature. Athletes completed three sessions, including a familiarisation session and two experimental sessions (dehydration (DEHY) and control (CON)) with judo-specific tests, including maximal handgrip strength test (HGS), judogi grip strength tests (JGST), and the Special Judo Fitness Test (SJFT). Results: Intergroup analysis revealed a significant increase in urine specific gravity (USG) and decreased body mass following DEHY condition compared to CON. Furthermore, significant decreases were determined in HGS, JGSTs, and a number of throws in the first and third series of SJFTs, as well as higher heart rate (HR) responses in the second and third series of SJFT and worse SJFT index in DEHY condition (p < 0.05). Conclusions: We concluded that 5% dehydration of body mass led to impairment in dynamic and isometric strength in upper limbs and in judo-specific performance, as well as elevated HR during the SJFT.
... Cases of exertion-related hyponatremia have been associated more commonly with overdrinking of solutepoor fluids during physical activity (Katch et al., 2017), whereby the development of encephalopathy from low serum sodium is implicated in reduced thermal awareness and heightened risk of concomitant heat illness (Miyasaka et al., 2013;Nolte et al., 2015). While other extrinsic factors have also been identified and investigated systematically (e.g., nonsteroidal use) (Fitzpatrick et al., 2024), the attention paid to intrinsic risk factors has been comparatively less and has centered largely on extremes of sodium losses from high rates of thermal sweating and/or sweat sodium concentration (Meyer et al., 2015). As demonstrated originally by Jerome Conn, patients affected by primary hypoadrenalism show a 50-to-60-fold greater concentration of sodium in sweat than subjects with adequate aldosterone responses (Conn, 1949). ...
Article
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We queried whether adrenal insufficiency attributable to non‐classic congenital adrenal hyperplasia (21 hydroxylase deficiency, 21OHD) might contribute to heat illness susceptibility. Patients referred to a specialist heat illness clinic (n = 2 with prior hyponatremia; n = 16 lacking documentary evidence) and controls (n = 16) underwent laboratory Heat Tolerance Assessment (HTA: 60–90 min walking, 60% relative intensity, 34°C heat), synthetic adrenocorticotrophic hormone stimulation (heat illness only) and CYP21A2 genotyping (hyponatremic heat illness only). Copeptin, cortisol, 17‐hydroxyprogesterone, and 21 deoxycortisol were assayed from blood at baseline and post‐HTA, with precursor product [17‐hydroxyprogesterone +21 deoxycortisol] expressed relative to cortisol. Saliva and urine were assayed for free cortisol (one hyponatremic case, controls). Versus controls, normonatremic heat illness exhibited greater (p < 0.05) serum cortisol across HTA, while hyponatremic heat illness showed blunted responses in aldosterone and free cortisol (salivary cortisol 1.6 and 1.6 vs. 6.0 [4.2, 19.4] and 4.2 [3.8, 19.2] nmol.L‐1; urine cortisol 19 vs. 117 +/− 71 nmol.L‐1). Hyponatremic heat illness demonstrated elevated precursor product consistent with 21OHD and multiple CYP21A2 mutations. One normonatremic case of heat illness also showed elevated precursor product. These data support the potential for 21OHD to precipitate heat illness under sustained physical stress and advance a case for targeted genetic screening.
... This condition makes it very easy for athletes to suff er injuries during training or competing. Fluid volume and fluid intake selection are also important for the body to be optimally hydrated (Murray, 2007;Meyer, 2016). Another study mentioned that consuming drinks with carbohydrates and electrolytes can improve performance and prevent the occurrence of injuries (O'Reilly & Wong, 2013). ...
Article
Full-text available
Physical exercise is the main factor in improving the performance of athletes. Physical exercise may cause fatigue and increase the risk of injury. Most athletes have experienced injuries during training or competing, such as muscle pain, sprains, muscle tension, bruises, and minor injuries. The majority of athletes lack knowledge regarding the management of injuries through appropriate nutritional interventions. The importance of proper nutrition therapy education as one of the solutions to reduce the risk of sports injury. The purpose of this study was to observe the change in knowledge about proper nutritional therapy in dealing with injuries in young soccer athletes at PSS Sleman Development Center. The study was conducted in July 2022. The provision of education was given at the Macanan Field, Prambanan, Yogyakarta. The respondents were 22 U-16 athletes at PSS Sleman Development Center. Athletes were given a knowledge questionnaire before and after the provision of education. Data were analyzed using statistical software with descriptive analysis and Wilcoxon Signed Rank Test. The increase in athletes' knowledge was measured from the knowledge score before giving education, which was 86,36 and after being given education increased to 89,09 with an average difference of 2,73 (p=0,366). The maximum score after providing education is 100 with a minimum score of 60. Providing education to athletes can increase athlete's knowledge and understanding of the importance of proper nutritional intake in reducing the risk of sports injury.
... Alguns autores sugerem resultados semelhantes a esse, como é o caso de Devlin et al. (2017). Os mecanismos que justificam os resultados de diminuição de percentual de gordura associada ao ganho de massa, quando aumentada a ingestão dos carboidratos, se dão principalmente pelo aumento da hidratação e pela renovação do estoque de glicogênio, acelerando a recuperação entre os treinos, levando assim ao aumento do desempenho esportivo [31] . Também os carboidratos fornecem metabólitos que poupam a oxidação de proteínas musculares, evitando assim a depleção da musculatura ao longo dos treinos e jogos [32] . ...
Article
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Introdução: Jogadores de futebol precisam ter alto nível de aptidão física para conseguir suportar as grandes demandas de treinamento e competições. Com isso, a nutrição esportiva tem se consolidado como uma ferramenta importante para aprimorar o rendimento dos atletas por meio da alimentação, seja pela composição corporal, prevenção de lesões, aceleração na recuperação ou pela correta utilização dos nutrientes, gerando energia de forma mais eficiente. Objetivo: Avaliar os efeitos do acompanhamento nutricional sobre a composição corporal e capacidade física de jogadores de futebol profissionais durante a pré-temporada. Metodologia: Um total de 26 jogadores de futebol profissional de um clube de primeira divisão do campeonato mineiro tiveram seus conhecimentos nutricionais e alimentação prévia avaliados e, então, iniciaram o acompanhamento nutricional ao longo de uma pré-temporada; foi feita a avaliação antropométrica, em que se estabeleceu o percentual de gordura pela técnica de aferição de pregas cutâneas, utilizando protocolo de Pollock, em cinco momentos durante a pré-temporada, bem como a avaliação de VO 2máx em dois momentos pelo teste incremental em esteira-aferições realizadas ao longo de cinco meses. Na análise estatística, foi testada a normalidade através do teste de Kolmogorov-Smirnov para validar a utilização de teste paramétrico, e na comparação do percentual de gordura e VO 2máx utilizou-se o teste t pareado. Para avaliar se houve diferença significativa, foi usada a ANOVA, considerando nível de significância p<0,05. Resultados: Os atletas avaliados consumiam dieta hipocalórica (2.021 ± 663 kcal/dia) e hipoglicídica (3,20 ± 1,45 g/kg/dia CHO) antes da intervenção nutricional, quando relacionada à recomendação para esse público. Após a prescrição dos planos alimentares adequados à modalidade e individualizados, observou-se boa aceitação da alimentação (3.725 ± 543 kcal/dia; 8,2 ± 1,1 g/kg/dia CHO), com diminuição significativa no percentual de gordura [11,35 vs. 10,34 %] e melhora significativa [52,22 vs. 53,77 ml(kg.min)-1 ] no desempenho aeróbico ao longo da pré-temporada. Conclusão: A intervenção nutricional individualizada com jogadores de futebol profissional ao longo de uma pré-temporada pode contribuir para promover melhora significativa da composição corporal e do desempenho aeróbico. Palavras-chave: Antropometria; Nutrição esportiva; Desempenho esportivo; Futebol. 71 Marques e Silva et al. Alteração na composição corporal na pré-temporada. Rev Bras ABSTRACT Introduction: Soccer players need to have high levels of physical fitness to be able to withstand the great demands of training and competitions. With this, sports nutrition has been consolidated as an important tool to improve the performance of athletes through nutrition, whether through body composition, injury prevention, acceleration in recovery or through the correct use of nutrients, generating energy more efficiently.
... Dehydration or extreme water loss can have adverse effects on performance and health (Gurses et al., 2018;Jetton et al., 2013). Dehydration is associated with decreased serum sodium levels and stroke volume, an increase in the core body temperature and, cardiac output, plasma fluid losses and haemoconcentration (Meyer et al., 2016). Besides, dehydration leads to adverse effects on cardiovascular functioning, i.e. an inability to maintain cardiac output and blood pressure (José et al., 1997). ...
Article
This study aimed to investigate the sex differences in short-term weight change and hydration status in judo athletes. Thirty-five men and 15 women judo athletes voluntarily participated in this descriptive and repeated measures design study. Body mass, urine-specific gravity (USG), and body composition of the athletes were measured at the official weigh-in and the competition day's morning. Body mass of the athletes increased during recovery time between official weigh-in and before the competition (time factor; F 1-48 = 71.81, p < 0.001), this increase was higher in men athletes compared to women athletes (time-sex interaction; F 1-48 = 6.56, p = 0.01). With RWG, USG values of the women and men athletes decreased (time factor; F 1-48 = 8.53, p = 0.005). However, most of the athletes were still in significant or serious dehydration state. Unchanged values of total body water rates (TBW) supported dehydration in athletes before the competition (time factor, F 1-48 = 2.9, p = 0.091; time-sex interaction; F 1-48 = 2.4, p = 0.122). The findings of the study indicated that RWG was higher in men athletes compared to women athletes, but hydration status was not affected by sex factor.Notwithstanding 15 hours of recovery between official weigh-in and the start of the competition, judo athletes were still in dehydrated state despite remaining within the limit set for RWG.
Article
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Organisations are aware of the need to maintain the mental health of their employees. People’s capacity to recognise and manage their moods and emotions is critical to sustainable mental health, performance, and quality of life, while failure to do so can result in underperformance, disengagement, and in some cases, mental illness. Employees of organisations that provide an appropriate strategy and support are likely to experience sustained psychological and mental health benefits. In this paper, we synthesise previous research into a theoretical framework distinguishing mood from emotion via both top-down (cognitive) and bottom-up (biological) factors. We propose a 4R model to help individuals Recognise a mood as distinct from an emotion, or vice-versa, and respond in one of three ways; Restore, Resolve, or Regulate. The model posits mood as an interoceptive signal of internal biological homeostasis, and emotion as a signal of external, often social, events that disrupt homeostasis; mood and emotion serve as internal and external bio-affective feedback loops, respectively. We propose that mood is modified positively by the restoration of homeostasis, whereas emotion is modified positively by behavioural resolution of the emotion-eliciting event. The 4R model is low-cost, preventative, and can be applied peer-to-peer in organisations without expert supervision.
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