Usage of Fruit-Infused Water for Prevention of Dehydration Due to Endurance Exercise

Abstract

This study aimed to extend previous investigation regarding its beneficial effects on changes of blood glucose. This experimental research was conducted from 06:00-12:00. Twenty-four young men (age 19-20 y.o.) were divided into three groups, Fasting-Exercise-Only (FEO), Fasting-Exercise-Water (FEW), and Fasting-Exercise with Fruit-Infused Water (FEF). Subjects underwent fasting for 12 h before the experimental day. The data of body weight (Kg) and macroscopic urine color were collected before and after exercise. Body weight in all experimental groups were decreased by 1% during endurance exercise. There were no differences in decrease of body weight between FEF and FEW groups compared to FEO group (p>.05). The change in urine color was significantly different between pre-exercise and post-exercise data (p<.05). The darkest urine color was observed in FEO group (4.75), followed by FEW group (4.25), while FEF group (3.63) did not reach dehydration level. In conclusion, fruit-infused water is suggested to be drink as a choice for fluid intake during exercise.

Full text

KEMAS 13 (3) (2018) 417-422
Jurnal Kesehatan Masyarakat
http://journal.unnes.ac.id/nju/index.php/kemas
USAGE OF FRUIT-INFUSED WATER FOR PREVENTION OF DEHYDRATION
DUE TO ENDURANCE EXERCISE
Mohammad Arif Ali, Setya Rahayu, Nanang Indardi, Gustiana Mega Anggita, Fatona
Suraya, Tri Rustiadi, Anggit Wicaksono, Yu-Shiuan Chen, Yun-Zhen Chang
Department of Sports Sciences, Faculty of Sports Sciences, Universitas Negeri Semarang, Indonesia
Department of Physical Education, Faculty of Sports Sciences, Universitas Negeri Semarang, Indonesia
Department of Sports Coaching Education, Faculty of Sports Sciences, Universitas Negeri Semarang,
Indonesia
New Taipei City Hospital Burn Rehabilitation & Post-Acute Care Center, Taiwan (R.O.C)
Yu Da University of Science and Technology, Taiwan (R.O.C)
Article Info
Article History:
Submitted January 2018
Accepted February 2018
Published March 2018
Keywords:
Exercise, Fluid Replace-
ment, Fruit-Infused Water
DOI
https://doi.org/10.15294/
kemas.v13i3.12977
Abstract
is study aimed to extend previous investigation regarding its benecial eects on
changes of blood glucose. is experimental research was conducted from 06:00-12:00.
Twenty-four young men (age 19-20 y.o.) were divided into three groups, Fasting-Ex-
ercise-Only (FEO), Fasting-Exercise-Water (FEW), and Fasting-Exercise with Fruit-In-
fused Water (FEF). Subjects underwent fasting for 12 h before the experimental day. e
data of body weight (Kg) and macroscopic urine color were collected before and aer ex-
ercise. Body weight in all experimental groups were decreased by 1% during endurance
exercise. ere were no dierences in decrease of body weight between FEF and FEW
groups compared to FEO group (p>.05). e change in urine color was signicantly dif-
ferent between pre-exercise and post-exercise data (p<.05). e darkest urine color was
observed in FEO group (4.75), followed by FEW group (4.25), while FEF group (3.63)
did not reach dehydration level. In conclusion, fruit-infused water is suggested to be
drink as a choice for uid intake during exercise.
 Correspondence Address:
Department of Sports Sciences, Faculty of Sports Sciences, Universitas Negeri Semarang.
Email : hiarifalikhan@mail.unnes.ac.id
pISSN 1858-1196
eISSN 2355-3596
duration exercise (typically aerobic exercise)
such as jogging, cycling, swimming, hiking,
etc. Indicators of dehydration are thirstiness,
dizziness, exhaustion, muscle spasm, loss
of body weight, change of urine color, and
vomiting (Sawka, M.N., 2007; Simpson, M.R.
and Howard, T., 2011).
Dehydration causes loss of mineral
and electrolytes (potassium, sodium, chloride
etc.), increase of body temperature, change in
cardiovascular system, disturbance in nerve
system, and eventually it will impair exercise
Introduction
Exercise has many benecial eects
on the body for all ages as long as it is done
correctly, properly, systematically, and regularly
(exercise should be adjusted to physiological
function). Exercise is able to improve the overall
health status of an individual (Hagen, K.B. et al,
2012; Locks, R.R. et al, 2012). Yet, exercise is
also known as physical stress which is able to
aect physiological processes inside the body.
One of consequences of exercise is dehydration
(loss of water) which is caused by long-

418
Mohammad Arif Ali / Usage of Fruit-Infused Water for Prevention of Dehydration
45 minutes since its intake (Ali, M.A. et al,
2016). erefore, the purpose of this study was
to investigate the eects of fruit-infused water
(combination of apple, banana and lemon) on
body weight and urine color as the markers of
dehydration caused by exercise.
Methods
is was an experimental research
study. e independent variable in this study
was fruit-infused water while the dependent
variables were body weight and urine color as
dehydration markers. It was conducted from
06:00 a.m. until 12:00 p.m.
Twenty-four young men (aged 19-
20 years) were divided into three groups,
1) fasting-exercise-only (FEO), 2) fasting-
exercise-water (FEW), and 3) fasting-exercise-
fruit-infused water (FEF). e following
procedure was implemented: 1) Subjects were
examined a week before the experiment. 2)
Informed consent was obtained from each
subject. 3) One day before the experiment,
all subjects received instructions regarding
the study protocol (12 h fasting from food).
4) On the day of the experiment, the subjects
were asked to sit and rest for 15 minutes. 5)
Two hours before exercise, the treatment drink
were administrated: 500 mL of either water or
fruit-infused water. 6) Urine collection and
body weight measurement (pre-exercise data)
were then taken less than 5 minutes before
exercise begun. 7) e exercise was then given.
performance (Murray, B., 2007). Previous
studies reported that 2% loss of body weight
could impair performance for about 7% - 29%
(Goulet, E.D.B., 2012). Dehydration during
exercise occurred in heat condition (Hackney,
K.J. et al, 2012).
Techniques or substances which can be
used in order to maintain exercise performance
called as ergogenic aids. It is classied into
nutrition (carbohydrate loading, drugs such
as usage of anabolic-androgenic steroid),
physiological condition, psychological
condition, and technique. As part of ergogenic
aids, the right nutrition is the essence of what
the body needs to maintain or improve exercise
performance, recovery from fatigue and injury
prevention. Several nutrition which had been
investigated and their eects were: 1) Caeine
could eectively improve body strength. It
also could be used for recreational sport or
sports which were related with resistance, 2)
Supplements which contain protein, vitamin,
mineral were recommended to be consumed
for injury prevention and good performance,
3) Beverages which contain carbohydrate and
electrolyte were able to increase or prevent the
decline of performance when they were taken
as uid substitute (Hackney, K.J. et al, 2012;
Higgins, J.P. et al, 2010; Jenkinson, D. M. and
Harbet, A.J., 2008).
In previous study, fruit-infused water
was able to elevate blood glucose approximately
Figure 1. Study Design

419
KEMAS 13 (3) (2018) 417-422
8) e administration of treatment drink:
150 mL of either water or fruit-infused water
during exercise every 15 minutes until 1 h had
elapsed. 9) e second collection of urine and
measurement of body weight (post-exercise
data) were performed immediately aer
exercised had nished. e study procedures
were approved by the Institutional Human
Study Committee of Faculty of Sports Sciences,
Semarang State University (Universitas Negeri
Semarang).
Fruit-infused water, which contained 212
Kcal/L of energy, was obtained from 138 g of
apple, 118 g of banana and 108 g of lemon. is
recipe also contained 61 g/L of carbohydrates
which is equal to 6% of a carbohydrate beverage
(recommended for sport drink). Mineral
water was used in this recipe. e following
procedure was followed for the fruit-infused
water: 1) e apple and lemon were washed.
e banana was peeled and thinly sliced. 2)
e fruits were mixed, (the juice and avor
ere extracted from the fruits by pressing and
twisting them with a mixer in batches before
and aer adding the liquid). Mixed fruit adds
avor quickly. 3) e fruits were then crushed
and the herbs were pressed with a avor wand
to release their avors. e fruits were crushed
gently because over-crushing could cause bitter
taste. 4) Instant infusion was then performed.
is process involves combining liquid with
mixed fruits and crushed herbs and pumping
the beverage with a avor wand. e wand was
held vertically while pumping it up and down.
e bottle/container was then closed and
placed in the refrigerator for a minimum of 30
min until the temperature reached 15-22 °C. At
this point it was ready to be drink (Ali, M.A. et
al, 2016).
e exercise was designed based on FITT
formula with some modications. It consisted
of running for 60 minutes with intensity of
70% - 80% of Maximum Heart Rate (MHR) on
treadmill with 30 incline. Target intensity was
monitored using indicators of: 1) awareness
that breathing is harder, and 2) ability to talk but
dicult to hold the conversation. In addition,
the subjects were asked to wear sauna jacket
during exercise in order to increase their body
temperature and sweating (Murray, B., 2007).
Body-Weight Scale Type ZT-120 was
used in this study. e subject step on it barefoot
and wearing underwear. e specications
of Body-Weight Scale Type ZT-120 were: 1)
Maximum weight which can be measured: 120
kg. 2) Height range: 70-190 cm. 3) Method of
measurement: Automatic. 4) Accuracy: 0.1 mg.
e steps of urine collection were: 1)
Collection of urine for about 2/3 of glass tube.
2) e color was then observed and matched
with color in the urine chart, converted into
number to determine the dehydration level
(Simpson, M.R. and Howard, T., 2011).
e data were expressed as the means ±
standard errors of the mean (SEMs). e t-test
was used to determine whether there were any
eects of fruit-infused water on body weight
and urine color. A level of P 0.05 was considered
statistically signicant.
Results and Discussion
Each of the experimental groups
consisted of 8 subjects. e average ages of all
subjects were 19 years old. e maximum heart
rate of all subjects was 200 bpm, and 70 percent
of the target heart rate (THR) was 140 bpm,
while 80 percent of THR was 160 bpm.
e Body Weight (Kg), in all experimental
groups were decreased by 1% during endurance
exercise (FEO: -880 g; FEW: -560 g; FEF: -790
g), (Table 2). e treatment drinks, either water
(FEW) or fruit-infused water (FEF), could not
prevent the 1% loss of body weight compared
with control group (FEO) (P> .05).
One percent decrease in body weight
during endurance exercise might lead to reduced
performance. However it was not enough to
impair the performance because loss of 2% in
body weight caused performance impairment
for about 7% - 29% (Goulet, E.D.B., 2012). Loss
of body weight which occurred in this study was
classied as modest/mild dehydration, which
was commonly found in team-sport (Osterberg,
K.L. et al, 2009). Moreover, previous studies
conrmed that loss of 1% to 2% of body weight
caused adverse eects on physiological function
and muscular endurance which was correlated
with change in cardiac output, and negatively
aect performance, but the muscle strength
was relatively unaected (Goulet, E.D.B., 2012;
Cengiz, A. and Demirhan, B., 2013).
1% to 2% loss of body weight could
impair cognitive function, led to reduction

420
Mohammad Arif Ali / Usage of Fruit-Infused Water for Prevention of Dehydration
in subjective perception of alertness and
ability to concentrate and increase in self-
reported tiredness and headache. In addition,
it also caused negative psychological eects on
performance such as increased fatigue, anger,
anxiety, decrease in mood and motivation, and
increased confusion (Cengiz, A. and Demirhan,
B., 2013).
Besides body weight, urine color also
could be used to investigate whether individual
was dehydrated or not (Simpson, M.R. and
Howard, T., 2011). e change in urine color
was clearly dierent between pre-exercise
with post-exercise data (P<0.05). Before
exercise treatment were given, subjects from
all experimental groups were in good hydrated
status as the urine score in each group were
2.63 in FEO group, 3.00 in FEW group, and
2.25 in FEF group. Aer exercise treatment, the
darkest urine color was observed in FEO group
(4.75), followed by FEW group (4.25) which
were classied into dehydration. Interestingly,
the change of urine color in FEF group (3.63)
did not reached dehydration level (Figure 2).
Exercise-induced dehydration was
observed. e loss of body weight led to
decrease in total body water, extracellular
water, blood volume and plasma volume (Relic,
D. et al, 2013). Dehydration during exercise is
primarily caused by the process of evaporation
(one mechanism of heat dissipation). Once the
temperature is increased, the sweat gland helps
the body to stabilize the core temperature.
Sweating caused loss of valuable uids from
Table 1. Characteristics of Subjects
Table 2. Change in Body Weight (Kg) aer Exercise

421
KEMAS 13 (3) (2018) 417-422
the body. e rate is dependent to individual
dierences, intensity of exercise, conditions of
environment, clothing, acclimatization state, and
hydration status. Individual with excess sweat
who undertakes intense exercise can become
dehydrated. Modest dehydration carries few
risks and can usually be treated by replacement
of lost salts and uids. Basically, drinking water
as an eort to prevent dehydration is better than
nothing. But drinking formulated liquid which
content substances which are appropriate for
physiological function is expected to be better.
Investigation about the usage of juice and
juice-like water (fruit infused water) on health
or athlete’s performance had been conducted
(Ali, M.A. et al, 2016; Januardi R. I., 2017). In the
study which was conducted by Januardi about
the eectiveness of fruit juice consumption as
pain reliever for bruise trauma in pencak silat
athletes, he discovered that the fruit juice was
eective to reduce muscle pain. Furthermore,
jamu cekok (Javanese herbal) also had been
studied regarding its stimulatory eect on
increasing the appetite and weight of toddler,
especially the usage of Curcuma aeroginosa,
Curcuma xanthorriza robx, Kaempferla
galanga L, Meniran phyllanthus niruri, Zingiber
americans, Carica papaya l, Curcuma domestica
val, bitter and rotten tempeh (Marni & Retno
Ambarwati, 2015).
Endurance exercise in this study
successfully caused dehydration by decrease of
1% of body weight. Unfortunately, the intake
uid either water or fruit-infused water could not
prevent the loss of body weight. Furthermore,
the change of urine color was suppressed only
by drinking fruit-infused water. Fruit-infused
water is suggested to be drink as a choice for
uid intake during endurance exercise.
Conclusion
Body weight in all experimental groups
were decreased by 1% during endurance
exercise. is loss could not be prevented either
using fruit-infused water or water compared
with FEO group (p>.05). e change in urine
color was clearly dierent between pre-exercise
and post-exercise data (p<.05). e darkest
urine color was observed in FEO group (4.75),
followed by FEW group (4.25), while FEF
group (3.63) did not reached dehydration level.
Fruit-infused water is suggested to be drink as a
choice for uid intake during exercise.
Acknowledgements
e authors would like to express
gratitude to the Faculty of Sports Sciences,
Universitas Negeri Semarang for the grant,
therefore this study could be successfully
conducted. e authors also would like to say
Figure 2. A. Urine Chart (Adopted from Simpson, M.R. and Howard, T., 2011), and B. Change in
Urine Color aer Exercise

422
Mohammad Arif Ali / Usage of Fruit-Infused Water for Prevention of Dehydration
thank you to all volunteers that gave much
supports to this study.
References
Ali, M.A., Mukarromah, S.B., Anggita, G.M., Suraya,
F., Anam, K. 2016. e Eect of Fruit-Infused
Water (Combination of Apple, Banana and
Lemon) on Blood Glucose in Young Men.
Pakistan Journal of Nutrition, 15(7): 693-695.
Cengiz, A. & Demirhan, B. 2013. Physiology of
Wrestlers’ Dehydration. Turkish Journal of
Sport and Exercise, 15(2): 1-10.
Goulet, E.D.B. 2012. Eect of Exercise-induced
Dehydration on Endurance Performance:
Evaluating e Impact of Exercise Protocols
on Outcomes Using A Meta-analytic
Procedure. British Journal of Sports Medicine,
47(11): 679-686.
Hackney, K.J., Cook, C.B., Fairchild, T.J., Ploutz-
Snyder, L.L. 2012. Skeletal Muscle Volume
Following Dehydration Induced by Exercise
in Heat. Extreme Physiology & Medicine, 1(3).
Hagen, K.B., Dagnrud, H., Moe, R.H., Osteras,
N., Kjeken, I., Grotle, M., Smedslud, G.
2012. Exercise erapy for Bone and Muscle
Health: An Overview of Systematic Reviews.
BMC Medicine, 10(167): 1741-7015.
Higgins, J.P., Tuttle, T.D., Higgins, C.L. 2010. Energy
Beverages: Content and Safety. Mayo Clinic
Proceedings, 85(11): 1033-1041.
Januardi Roy Irawan. 2017. e Eectiveness of
Passion Fruit Juice Consumption as Pain
Reliever for Bruise Trauma in Pencak Silat
Athletes. Jurnal Kesehatan Masyarakat,
12(2): 96-101.
Jenkinson, D. M., Harbert, A. J. 2008. Supplements
and Sports. e American Family Physican,
(www.aafp.org./afp).
Locks, R.R., Costa, T.C., Koppe, S., Yamaguti, A.M.,
Garcia, M.C., Gomes, A.R.S. 2012. Eects
of Strength and Flexibility Training on
Functional Performance of Healthy Older
People. Revista Brasileira de Fisioterapia,
16(3): 184-190.
Marni & Retno Ambarwati. 2015. Khasiat Jamu
Cekok Terhadap Peningkatan Berat Badan
pada Anak. Jurnal Kesehatan Masyarakat,
11(1): 102-111.
Murray, B. 2007. Hydration and Physical
Performance. Journal of the American College
of Nutrition, 26(5): 542S-548S.
Osterberg, K.L., Horswill, C.A., Baker, L.B. (2009).
Pregame Urine Specic Gravity and Fluid
Intake by National Basketball Association
Players During Competition. Journal of
Athletic Training, 44(1): 53-57.
Relic, D., Hassler, E., Jost, J., Friedmann-Bette,
B. 2013. Rapid Weight Loss and the Body
Fluid Balance and Hemoglobin Mass of Elite
Amateur Boxers. Journal of Athletic Training,
48(1): 109-117.
Sawka, M. N., Burke, L. M., Eichner, E. R., Maughan,
R. J., Montain, S. J., Stachenfeld, N. S. 2007.
Exercise and Fluid Replacement. Journal
of the American College of Sports Medicine,
20(10): 377-390.
Simpson, M. R. and Howard, T. 2011. Selecting
and Eectively Using Hydration for Fitness.
American College of Sports Medicine
Consumer Information Committee.