Liverpool John Moores University
Liverpool, Merseyside, L3 3AF, United Kingdom
NCT Number: NCT05491122
Chronic low water intake may raise the risk of morbidity and mortality by influencing key water regulating hormones (e.g., AVP), which are known to modulate glucoregulation and renal function. For example, AVP stimulates the HPA axis to release the glucocorticoid stress hormone cortisol with potentially far-reaching effects on metabolism, immunity and inflammation. One study observed elevated blood cortisol in a group of low water drinkers, albeit cortisol was measured at one time of day only. However, in the field of psychobiology, researchers have traditionally related more dynamic assessments of cortisol with health outcomes; by evoking cortisol responses to acute standardised laboratory stressors, such as The Trier social stress test. More recently, researchers have appreciated the importance of circadian variability in cortisol levels, by examining influences on, and consequences of individual differences in the diurnal variation of cortisol. The major measurable parameters of the diurnal variation are; the cortisol awakening response (CAR), which is the rise in cortisol during the first 30-45 minutes following awakening, and the diurnal cortisol slope, which is the rate of decline in cortisol levels across the day, from morning to evening. These parameters are considered to reflect different aspects of HPA axis function; with the CAR best reflecting the adrenal capacity to respond to stress and awakening and diurnal slope more indicative of daily cortisol exposure. Although distinct, both blunted CAR and a flattened diurnal cortisol slope appear to be consistent markers of HPA axis dysfunction and related to a variety of poor health outcomes. Therefore, it has been recommended that contemporary research should simultaneously estimate an individual's awakening cortisol responsiveness, and diurnal slope, thereby capturing distinct and important components of HPA axis function. The shared pathways that regulate body water, diurnal variation in cortisol and our response to stress underpin the broad aim of this research programme: to investigate the influence of low and high fluid intake on diurnal cortisol variation and the cortisol response to acute stress.
The aims of this study are to investigate:
1. The influence of a change in water intake behaviour on diurnal saliva cortisol variation as assessed by the CAR (primary outcome) 2. The influence of a change in water intake behaviour on biomarkers of hydration and thirst as assessed by urine osmolality, urine colour and thirst sensation. 3. The influence of habitual low and high total fluid intake on saliva cortisol response to an acute psychological stress (secondary outcome) 4. Investigate the influence of a change in water intake behaviour on plasma biomarkers of hydration as assessed by plasma osmolality and plasma copeptin (exploratory outcome)
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Notify Me18 year–35 year
All sexes
Interventional
Not applicable
Liverpool, Merseyside, L3 3AF, United Kingdom
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Participants who...
Exclusion criteria
Participants who…
•...have a daily total fluid intake of: Men: between 1.6 litres per day and 2.9 litres per day OR Women: between 1.5 litres per day and 2.5 litres per day.
1-week intervention where the intake of drinking water will either be increased (if habitually low) or decreased (if habitually high). The total fluid intake (TFI) prescriptions during the intervention are derived from the mean TFI of habitually high and habitually low drinkers from a sex, age and country matched population. Specifically, habitually high drinkers will be permitted a TFI of 1.3 L/day and habitually low drinkers will be permitted a TFI of 3.5 L/day for men and 3.3 L/day for women. Participants will be instructed to maintain their usual intake of other beverages i.e., tea/coffee to achieve their target TFI. The diurnal saliva cortisol response at rest will be examined at the end of both experimental periods and the saliva cortisol response to an acute psychological stress will be examined at the end of the habitual experimental period only.
Time frame: Assessed during the first 45 minutes after awakening
A biomarker for Hypothalamic Pituitary Adrenal activity; a naturally occurring increase in cortisol upon waking, assessed by ELISA
Time frame: Mid-afternoon urine samples will be collected on days 2, 5, 6 and 7 during the habitual and on days 10, 13 and 14 of the intervention periods. T
The concentration of osmotic solutes present in the urine, measured using a freezing point depression osmometer;
Time frame: Delta changes (increase/ decrease) in cortisol response (calculated by subtracting the baseline cortisol value from the peak post-stress induction level (-30 minutes pre-stress minus 10 minutes post-stress)
Changes in the concentration of saliva free cortisol assessed by ELISA
Time frame: Mid-afternoon urine samples will be collected on days 2, 5, 6 and 7 during the habitual and on days 10, 13 and 14 of the intervention periods. T
urine colour which is a common urinary marker used for assessing hydration status, assessed using a urine colour chart has been developed to assess urine concentration in healthy humans;
Time frame: hirst sensation will be collected for daily for a total of 15 days across the habitual and intervention periods.
subjective rating of thirst will be obtained from a 0-9 thirst sensation scale (0 = "not thirsty at all" to 9 = "very, very thirsty")
Time frame: Bedtime minus wake-up level divided by total time awake, collected across days 6 & 7 (habitual period) and days 14 & 15 (intervention period
A biomarker for Hypothalamic Pituitary Adrenal activity; the rate of decline in cortisol concentration across the day, from morning to evening
Time frame: Continuously assessed from 30 minutes before to 60 minutes after the stress tests and control tests]
Continuous measurement of heart rate will be assessed using a telemetric chest strap.
Time frame: Change from baseline (before stress challenge) to after stress challenge (immediately after acute psychological stress and 60 minutes after the test) will be compared.
assessed using the state scale of the state trait anxiety inventory (STAI-S), consisting of a 20-item scale for measuring the intensity of anxiety as an emotional state (S-Anxiety). The range of possible scores for form Y of the STAI varies from a minimum score of 20 to a maximum score of 80. STAI scores are commonly classified as "no or low anxiety" (20-37), "moderate anxiety" (38-44), and "high anxiety" (45-80)
Time frame: Change from baseline (before stress challenge) to after stress challenge (immediately after acute psychological stress and 60 minutes after the test)
As assessed by the Positive and negative affective schedule (PANAS), this will be used to measure the emotional response to acute psychological stress. The PANAS consists of 10 items for positive affect and 10 items for negative affect, which are answered on a 5-point likert scale (from 1 = "very slightly or not at all all", to 5 = "extremely."). Ratings are summed to a positive and a negative affect score. Separate items for the Positive and negative affect scores range from 10 - 50, higher scores represent higher levels of positive and negative affect separately .
Time frame: assessed on day 7 (habitual period) and day 15 (intervention period) will be compared between habitual low and high drinkers and in response to the intervention weeks (increased or decreased water intake)
A marker of intracellular osmolality, measured using a freezing point depression osmometer
Time frame: assessed on day 7 (habitual period) and day 15 (intervention period) will be compared between habitual low and high drinkers and in response to the intervention weeks (increased or decreased water intake)
the influence of a change in water intake behaviour on plasma copeptin
Liverpool John Moores University
Other
Investigating the Influence of Fluid Intake on Saliva Cortisol: Diurnal Variation and Acute Response to Psychological Stress in Young Adults
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