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Year : 2022  |  Volume : 22  |  Issue : 2  |  Page : 82-86

A comparison of body composition and blood lipid indices among Kho-Kho players based on water intake pattern

1 Department of Sports, Faculty of Sports, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
2 MYAS-NIN Department of Sports Science, ICMR – National Institute of Nutrition, Hyderabad, Telangana, India

Date of Submission14-Jun-2022
Date of Decision26-Jun-2022
Date of Acceptance07-Jul-2022
Date of Web Publication30-Aug-2022

Correspondence Address:
Prof. Gulshan Lal Khanna
Department of Sports, Faculty of Sports, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjsm.sjsm_12_22

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Purpose: Water intake and its likely association with body composition are under exploration in recent years. However, studies done on athletes are scarce in this direction. The present study aimed to understand the difference between body composition and blood lipid indices of Kho-Kho players based on water intake pattern.
Methods: Forty-five male Kho-Kho players aged between 18 and 30 years attending a national camp were recruited for the study. The players were cross-sectionally divided into two groups: (1) low water consumption (LWC; <1 ml/kcal) and (2) adequate water consumption (AWC; >1.0 ml/kcal) based on the water consumption recommendations (IOM, 2005) and evaluated the differences in anthropometric measurements, body composition, total water, energy and nutrient intakes, and blood lipid indices between groups using the t-test.
Results: We found a significant difference between LWC and AWC for total water intake (P < 0.01), body mass (P < 0.01), body fat % (P < 0.01), endomorphic somatotype (P < 0.01), girths (P < 0.01), serum triglycerides (P < 0.01), and very low-density lipoprotein (P < 0.05).
Conclusion: Lower water intake may increase body mass and fat, endomorphism, and blood lipid indices. Hence, AWC could be useful in the maintenance of ideal body composition, physique, and blood lipid indices in Kho-Kho players.

Keywords: Blood lipid indices, body composition, Kho-Kho, water intake

How to cite this article:
Kalpana K, Khanna GL, Nagajyothi A. A comparison of body composition and blood lipid indices among Kho-Kho players based on water intake pattern. Saudi J Sports Med 2022;22:82-6

How to cite this URL:
Kalpana K, Khanna GL, Nagajyothi A. A comparison of body composition and blood lipid indices among Kho-Kho players based on water intake pattern. Saudi J Sports Med [serial online] 2022 [cited 2023 Sep 29];22:82-6. Available from: https://www.sjosm.org/text.asp?2022/22/2/82/355191

  Introduction Top

Kho-Kho is a popular ancient tag team sport invented in Maharashtra, India, which involves chasing and touching a person.[1] It is an intermittent sport that involves physical events of maximum exertion of short distance, speed, agility, explosive power, and endurance. Kho-Kho game has an effect on the respiratory, circulatory, nervous, muscular systems and helps in developing neuromuscular coordination.[2] Individual fitness and flexibility plays a crucial role in the team success of Kho-Kho which can be accomplished through exercise, nutrition, and rest.

Right nutrition has been shown to help in improving mental and physical performance. Water is an important nutrient for performance enhancement which is usually overlooked by the sports fraternity. Proper hydration helps in maintaining blood pressure, reducing the strain of the cardiovascular system. Adequate water consumption (AWC) improves blood flow and circulation and thus delivers oxygen and nutrients to working muscles.[3] Hypohydration can attenuate endurance, strength, and power.[4] Loss of body mass as little as 1%–2% through sweat can increase heart rate, core temperature, heat storage, utilization of muscle glycogen, and decrease in cardiac output. Dehydration leads to decrease in concentration, increase in reaction time, short-term memory, anxiety, and time to exhaustion.[5],[6],[7],[8],[9],[10]

Regarding the above factors, novel studies focusing on understanding the deeper knowledge on water consumption and its influence on health are of great interest. In recent years, water intake and its relation with body composition and energy expenditure patterns have gained greater attention. Most of the studies have shown a positive effect on the body composition with higher water intake.[11],[12] However, these studies have been conducted on nonathletes. Further, information on influence of water intake on body composition and blood lipid indices of athletes is scarce. Therefore, the present study aimed to understand the impact of water consumption on body composition along with blood lipid indices among Kho-Kho players as these are the two most important factors necessary for an athlete's successful performance.

  Methods Top


Forty-five male Kho-Kho players aged between 18 and 30 years attending a national camp were recruited for the study. All the procedures were followed as per the guidelines laid down in the Declaration of Helsinki.[13] Institutional ethical committee approval was received to conduct the study. The players were informed about the experimental protocol and their written consent was received. The inclusion criteria were an absence of any illness or injury and refusal of informed consent. The exclusion criteria were physical or mental illness or injured athletes, dependence of alcoholism or drug abuse or dependence, and use of active medication.

Anonymity was preserved for all players.

Anthropometric measurements and body composition

All the anthropometric measurements were done after an overnight fast of 8–12 h. Height and weight were measured following a standard protocol.[14] Height was measured using a stadiometer with the athlete maintaining the Frankfurt plane. Body mass was recorded with minimal clothing, after voiding the bladder, to the nearest 0.1 kg using a digital weighing machine. Body mass index (BMI) was calculated from weight (kg)/height (m2). Skinfold measurements (biceps, triceps, subscapular, and supra-iliac) were taken using Holtain calipers (U. K) with 0.2-mm accuracy. Accordingly, body density[15] and body fat percentage[16] were calculated using the equations. Girth measurements were taken accurately to 0.1.cm using an anthropometric measuring tape: flexed and tensed right mid-upper arm, legs hanging for the calf, the narrowest point below the ribs for waist, anterior superior iliac spine, or broadest girth below the waist for the hip. Holtain sliding caliper was used to measure the biepicondylar humerus and bicondylar femur breadths. Heath-Carter method (1967)[17] was considered to estimate the somatotype. Two measurements were taken from each site, and the mean was calculated. If the difference was greater than 5% between the two measurements, a third measurement was taken, and the median value was considered.

Estimation of total water intake and requirement

Total water intake was calculated from water intake from food, metabolic water, and beverage intake. Water intake from food was calculated from moisture content in food.[18] The food intake pattern of Kho-Kho players was assessed using 24-h recall plus weighment method.[19] Based on the information, calorie and macronutrient intakes were calculated using the Indian Food Composition Data Tables, National Institute of Nutrition, Hyderabad.[18] Water generated through macronutrient oxidation (carbohydrates/100 g, protein/100 g, and fats/100 g; 55 ml, 41 ml, and 110 ml of water) was considered for metabolic water estimation.[20],[21] Twenty-four-hour recall plus weighment method was considered to assess the beverage intake pattern. The water requirement per day was calculated based on the recommendations of IOM (2005),[20] i.e., 1–1.5 ml of fluid/cal. Based on the water consumption, the players were cross-sectionally divided into two groups: (1) low water consumption (LWC; <1 ml/kcal) and (2) AWC (>1.0–1.5 ml/kcal).

Lipid indices

The players were asked to maintain a similar diet which was followed regularly on the previous night. After an overnight fast of 8–12 h, the blood sample (5 mL) was taken via vein puncture. The blood sample was transferred immediately from the syringe into vacutainers, centrifuged at 4000 rpm for 10 min to separate the serum. The serum samples were stored at 18°C till further analysis, and the test was performed within 72 h after obtaining the blood sample for lipid indices. An automatic clinical chemistry analyzer, Erba (Lachema) XL200, Germany, was used to perform the tests.

Statistical analysis

Statistical analysis was done using the Statistical Package for Social Sciences (SPSS; IBM, New York, USA) version 27.0. Mean and standard deviation were computed for all the variables. Frequency was computed to know the prevalence of low water intake among Kho-Kho players. Differences between LWC and AWC for anthropometric measurements, body composition, somatotype, water intake, energy and nutrient intakes, and blood lipid indices were analyzed through independent sample t-test. Differences were set at P < 0.05 and P < 0.01.

  Results Top

The anthropometry and body composition of Kho-Kho players are summarized in [Table 1]. The body weight and body fat percentage were significantly higher (P < 0.05) in LWC than AWC, but the difference was not significant for BMI. Regarding the circumferences, LWC had a significantly higher mid-upper arm circumference (P < 0.05) and waist circumference (P < 0.05). Concerning the somatotypes, LWC had a higher endomorphic variable compared to AWC.
Table 1: Anthropometry and body composition of Kho-Kho players

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[Table 2] shows the water intake pattern of Kho-Kho players. We found that intake of water from beverages and total water intake were significantly higher (P < 0.01) in AWC than LWC. Intake of water from food and metabolic water was not significantly different between the groups. The energy and macronutrient intakes of Kho-Kho players are given in [Table 3]. The energy and macronutrient intakes of AWC were higher than LWC, but a significant difference was not found. The serum lipid profile showed significantly higher triglycerides (P < 0.01) and very low-density lipoprotein (VLDL) (P < 0.01) in LWC as compared to AWC [Table 4].
Table 2: Water intake pattern of Kho-Kho players

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Table 3: Macronutrients intake pattern of Kho-Kho players

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Table 4: Serum lipid profile of Kho-Kho players

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  Discussion Top

Water is likely the most underrated of all beverages, but it is a vital performance-enhancing nutrient in prolonged exercise.[22] Prolonged exercise under hot and humid conditions causes fluid and electrolyte losses.[23],[24] Loss of body mass as little as 1%–2% through sweat loss can increase the heart rate, core temperature, heat storage, muscle glycogen use, as well as a decrease in cardiac output and cognitive function that include poor concentration, increased reaction time, and short-term memory and anxiety, and time to exhaustion.[5],[6],[7],[8] Hence, consumption of adequate fluid intake before, during, and after exercise is important for the maintenance of biological, physiological, and cognitive functions.[25]

Kho-Kho sport demands speed, agility as well as endurance activity with skill included in it, which helps in building physical fitness, strength, stamina, speed, and coordination along flexibility.[1] These specific skills are attained when physical fitness and health is maintained. Maintenance of euhydration is very important for increased exercise performance. The present study is a unique exploration of the relationship between volume of water consumption and its impact on body composition, energy and macronutrient intakes, and blood lipid profile of Kho-Kho players. Most players who participated (37.8%) were consuming <1 ml/kcal in accordance with the recommendations provided by the Institute of Medicine of the United States of America (IOM), 2005.[20]

Beverage consumption and its association with obesity risk factors and non-communicable diseases are under investigation.[26] The present study identified a significant difference between water intake and body composition, somatotype, and blood lipid indices of Kho-Kho players. Recent studies have also observed reduced body weight, body fat mass, and waist circumference with an adequate amount of water consumption.[12],[27],[28] Cellular dehydration and greater dehydration risk were observed in obese people.[29],[30] Physical characteristics such as body mass, muscle mass, body fat, and body surface area affect thermoregulation along with environmental factors that can contribute to the occurrence of heat illness. In addition, inadequate fluid intake can be one of the primary precursors to heat illnesses.[31] Athletes should consume adequate amounts of water to avoid dehydration and maintenance of body composition for health and performance. Another point here to be noted is, the macronutrient intake pattern was similar in both the groups but still has higher body composition, girths, and endomorphic somatotype. Besides, we have observed higher serum triglycerides and VLDL levels in LWC indicating water consumption as an important component for maintaining normal blood lipid levels. A few of the investigations have demonstrated that water intake and hydration status other than diet and physical activity can be the factors in weight regulation and obesity.[32],[33] Decreased water consumption can increase LDL cholesterol and decrease high-density lipoprotein cholesterol in children, making the water a contributing factor to preventing obesity and heart complications.[11] However, these studies have been conducted on nonathletes and can be explored in athletes. According to Boschmann et al.,[34] water can stimulate sympathetic activation, thereby thermogenesis, and increase resting energy expenditure by 30%. However, this cannot give us a consistent answer. The preliminary exploration of this study in interpreting the data with body composition and blood lipid indices according to the water consumed by the Kho-Kho players has given some direction, but recommends further in-depth research on a greater number of athletes to get a conclusive result.


This paper is a cross-sectional study, attempted to examine the effect that water can create on anthropometry, body composition, somatotype, and lipid indices in Kho-Kho players, but the sample size taken for this study is a limitation. In addition, players underreporting and misreporting of food intake and beverage have influenced total water intake.

  Conclusion Top

Our results indicate that there is a clear difference in body composition, somatotype, and blood lipid indices with water intake. Lower water intake may increase body mass and fat, endomorphism, and blood lipid indices. Hence, AWC could be useful in the maintenance of ideal body composition, physique, and blood lipid indices which could contribute to maintain physical fitness and achieving success for the Kho-Kho players


The authors would like to thank the Kho-Kho Federation of India and SGT University for the support.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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  [Table 1], [Table 2], [Table 3], [Table 4]


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