Hydration in the Cold of Winter

November 11, 2015

While I’ve spent a large part of my career thinking about how to improve performance in hot weather conditions, the reality is that humans are extremely well suited to cope with the heat. When it gets hot, we easily and effectively redirect blood flow to help dissipate heat to the skin, we sweat to help cool that skin, we make quick hormonal adaptations that increase our ability to hold and store water, and we become more efficient at this whole process the more we are exposed to the heat.

In stark contrast, humans have very few and fairly unsubstantial responses to the cold. Blood vessels can clamp down to help keep warm blood at the core, we might shiver to increase our metabolic rate, and for some individuals, after consistent exposure to the cold an increase in the core temp during exercise or an input of heat into the core can cause blood flow to increase to the hands and feet helping to keep the extremities warm despite the cold – something known as the “Hunting Response.” These responses, however, do little to actually keep us from losing precious body heat. Unlike some animals, our fur is limited and we can’t just burn fat to create heat, so our only real option for preventing hypothermia or other cold weather related injuries like frostbite or exercise-induced bronchoconstriction depends on our behavior and technology.

When we exercise in the cold, we might be creating extra heat, but the combination of sweat, movement, and an increased ventilation rate can create some real problems. Ironically, one of those problems is the loss of even more heat and the risk of getting too cold once we stop exercising because of excess moisture from sweat. In fact, Eric Larsen, who we supported on an attempt to ride to the South Pole, faced temperatures in Antarctica that were so cold that he had to find an exercise intensity that was just hard enough to keep his bicycle moving, but easy enough that he would minimize any sweat production or risk freezing when he stopped.

That extra heat production from exercise and the ease at which we can lose that heat in the cold also puts extra strain on our fuel stores. In particular, when exercising in the cold, we preferentially rely on carbohydrate in the form of stored glycogen. A lot of that is due to an increase in our fight or flight response – activation of our sympathetic nervous system that works in the background without conscious attention to keep us charging under stress. Cold as a basic stress causes our sympathetic nervous system to light up which can cause us to waste precious energy, especially carbohydrate, making it a lot easier to bonk or hit the wall in the cold. Despite having ample fat stores available to us, once we run out of carbohydrate, we risk becoming hypoglycemic (low blood sugar). Since our nervous system and brain rely solely on glucose (i.e., sugar or carbohydrate) we can get really loopy when that happens. While becoming hypoglycemic at any temperature is bad enough, becoming hypoglycemic and hypothermic can be even worse since in and of itself, hypothermia can also lead to a host of issues like confusion, apathy, irritability, and cardiac arrhythmias. Thus, making sure we have plenty of food available, especially simple sugar, can be a lifesaver when it’s cold or when we get cold.

This increase in sympathetic tone can also result in something known as cold diuresis. Essentially, when we’re cold or exposed to the cold we pee – a lot. As our sympathetic tone increases, it causes our blood vessels to stiffen which increases our blood pressure. At the same time, the cold causes blood vessels in our skin and periphery to constrict which drives more blood to our central blood volume further increasing blood pressure. This ultimately causes our kidneys to respond by pushing out dilute urine into our bladder and inadvertently dehydrating us even if we previously drank enough.

Another issue is that cold air is extremely dry air, which can damage our delicate lungs which function best when the air we breathe is brought up to 100% humidity and to body temperature (37.0˚C / 98.6˚F). This is easily done at warm temperatures, but at a given relative humidity, the colder the temperature the less water the air holds. As an example, at 100% relative humidity, there is 44% less water in the air from 0˚C compared to 10˚C (5 grams of water per liter of air versus 9 grams of water per liter of air). So when people say “it’s too cold to snow” it probably is too cold to snow since the air can’t hold the moisture. The net result is that as the temperature drops, we lose more water and heat through our lungs to humidify and heat the air we breathe. Specifically, depending upon the humidity, at 0˚C (32˚F), we can lose anywhere from 20-30% more water through our lungs compared to 20˚C (68˚F), and from 40-50% more water compared to when the temperature is at 30˚C (86˚F).

At rest, when our ventilation rate is only about 5 liters of air per minute, the amount of water we lose through our lungs is fairly insignificant - about 10.5 ml of water per hour at 0˚C and 6.5 ml of water per hour at 30˚C. But this small amount can become a really big deal when we are exercising and ventilation rates can be as high as 100 to 150 liters of air per minute. At a ventilation rate of 100 liters per minute, we can lose as much as 211 ml of water in an hour at 0˚C through our lungs versus 132 ml of water in an hour at 30˚C. This difference isn’t trivial since in many cases, our lungs can’t actually keep up with this differentially and the air we breathe isn’t fully brought up to temperature and humidity in the lower airways. This can lead to inflammation, damage to our airway structure, and a higher prevalence of exercise-induced bronchoconstriction and asthma in the cold winter season – something that can be worsened by dehydration or inadequate fluid replacement in the cold.

The question, however, is if all of this actually adds up to real dehydration in cold weather. While there are obvious risks of not getting adequate fuel and hydration in the cold and while there is a good rationale for how one might be at risk for becoming dehydrated in cold environments, there’s not too much research on hydration status in cold temperatures. This may be due to the fact that it’s not actually a problem and not something that we either worry about or study. But, that lack of attention may also be a problem in and of itself. In fact, in a recent study examining hydration status and sodium balance in a group of junior women’s soccer players in a cool environment, the players did not drink enough or consume enough sodium despite very low sweat rates (Gibson, et al. 2012). In another study, that examined water turnover and core temperature on Mt. Rainier, researchers found that hydration demands during the ascent in a group of seven novice climbers was elevated and that the climbers lost a significant amount of fluid despite not showing an elevation in core temperature (Hailes, et al. 2012). In both situations, dehydration occurred despite a lack of a heat stress and perhaps because of a lack of drive to drink due to the cold. Because, even a small amount of dehydration can hurt performance (Yoshida, et al. 2002), it stands to reason that staying focused on hydration, even in the winter, can help improve one’s performance.

With all of this in mind, it’s obviously important to first and foremost do everything you can to stay warm when temperatures are cold. For the most part, much of this comes down to our behavior – to being prepared and having the right gear if you’re planning to head out and exercise in the cold. Investing in the right clothing is obviously the first place to start – a high quality and tight wicking base next to the skin, an insulating wool over that, high loft materials for extra warmth as another layer of defense, and a final barrier to stop the wind on top. Add to that gloves, a good neck gaiter, something to cover your face and create a barrier to help maintain moisture lost through breathing, good head protection and booties to keep your feet warm. Also, instead of putting air activated toe and hand warmers around your feet and hands, try putting them next to your chest and see if that “Hunting Response” works for you.

Beyond the right clothing, it’s just as important to focus on your food and hydration in the winter as it is anytime of the year with some subtle differences. First and foremost, realize that your need for carbohydrate at any given intensity is probably going to be higher when it’s cold. So don’t forget to eat and to bring those simple sugars outdoors with you. Next, just because you may not sense that you are losing a lot of fluid or you may not feel that you need to drink, making sure you stay on top of your hydration, especially with something warm. It’s a lot easier to keep your core temperature up from the inside out than it is from the outside in, so having an insulated bottle and keeping some warm hydration product can be a small but significant thing. Our Hydration Drink Mixes can be served hot to help with this. We wanted something to use on those cold days that would taste good hot and that would remind us to bring something hot out with us that had some calories and electrolytes.  Finally, use common sense. Sometimes it’s best to just stay indoors and go to the gym, get on a treadmill, or ride the trainer. Be smart out there and use your head. In cold weather, it’s really our best tool.

For more on the topic, check out the references below:

Gibson, J. C., Stuart-Hill, L. A., Pethick, W., & Gaul, C. A. (2012). Hydration status and fluid and sodium balance in elite Canadian junior women’s soccer players in a cool environment. Appl Physiol Nutr Metab, 37(5), 931-937.

Hailes, W. S., Cuddy, J. S., Slivka, D. S., Hansen, K., & Ruby, B. C. (2012). Water turnover and core temperature on Mount Rainier. Wilderness Environ Med, 23(3), 255-259.

Kippelen, P., Fitch, K. D., Anderson, S. D., Bougault, V., Boulet, L. P., Rundell, K. W. et al. (2012). Respiratory health of elite athletes - preventing airway injury: a critical review. Br J Sports Med, 46(7), 471-476.

Marek, E., Volke, J., Muckenhoff, K., Platen, P., & Marek, W. (2013). Exercise in cold air and hydrogen peroxide release in exhaled breath condensate. Adv Exp Med Biol, 756, 169-177.

McMahon, J. A., & Howe, A. (2012). Cold weather issues in sideline and event management. Curr Sports Med Rep, 11(3), 135-141.

Sue-Chu, M. (2012). Winter sports athletes: long-term effects of cold air exposure. Br J Sports Med,46(6), 397-401.

Yoshida, T., Takanishi, T., Nakai, S., Yorimoto, A., & Morimoto, T. (2002). The critical level of water deficit causing a decrease in human exercise performance: a practical field study. Eur J Appl Physiol,87(6), 529-534.

(2011). Update: cold weather injuries, U.S. Armed Forces, July 2006-June 2011. MSMR, 18(10), 14-18.

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