Validity of combined hydration self-assessment measurements to estimate a low vs. high urine concentration in a small sample of (tactical) athletes

Eur J Nutr. 2024 Feb;63(1):185-193. doi: 10.1007/s00394-023-03254-1. Epub 2023 Oct 5.

Abstract

Purpose: Relationships between body weight, urine color (Uc), and thirst level (WUT) have been proposed as a simple and inexpensive self-assessment method to predict dehydration. This study aimed to determine if this method also allowed us to accurately identify a low vs. high urine concentration in (tactical) athletes.

Methods: A total of n = 19 Army Reserve Officer Training Corps cadets and club sports athletes (22.7 ± 3.8 years old, of which 13 male) were included in the analysis, providing morning body weight, thirst sensation, and Uc for five consecutive days. Each item received a score 0 or 1, resulting in a WUT score ranging from 0 (likely hydrated) to 3 (very likely dehydrated). WUT model and individual item outcomes were then compared with a ≥ 1.020 urine specific gravity (USG) cut-off indicating a high urine concentration, using descriptive comparisons, generalized linear mixed models, and logistic regression (to calculate the area under the curve (AUC)).

Results: WUT score was not significantly predictive of urine concentration, z = 1.59, p = 0.11. The AUC ranged from 0.54 to 0.77 for test days, suggesting a fair AUC on most days. Only Uc was significantly related to urine concentration, z = 2.49, p = 0.01. The accuracy of the WUT model for correctly classifying urine samples with a high concentration was 68% vs. 51% of samples with a low concentration, resulting in an average accuracy of 61%.

Conclusion: This study shows that WUT scores were not predictive of urine concentration, and the method did not substantially outperform the accuracy of Uc scoring alone.

Keywords: Hydration status; Self-assessment; USG; Urine specific gravity; WUT.

MeSH terms

  • Adolescent
  • Adult
  • Athletes
  • Body Weight
  • Dehydration* / diagnosis
  • Dehydration* / urine
  • Humans
  • Male
  • Self-Assessment*
  • Urinalysis / methods
  • Young Adult