Fannypack
01-18-2007, 19:28
Thirst is best water gauge
Contrary to earlier thinking, excess fluid intake puts athletes at risk.
By Carrie Peyton Dahlberg - Bee Staff Writer
Last Updated 1:12 am PST Tuesday, January 16, 2007
Story appeared in METRO section, Page B1
(http://www.sacbee.com/296/story/108285.html#comments_here)The shattering death of a young Rancho Cordova woman after a water-drinking contest Friday underscores a risk that goes beyond stunts and hazing, also claiming unwary marathoners and other endurance athletes.
Even some doctors don't realize that a major shift has taken place in the past few years, changing the mantra from "hydrate, hydrate, hydrate" to "drink when you're thirsty," said Dr. Meredith Bean, a sports medicine specialist at Kaiser Permanente's South Sacramento Medical Center.
While the plummeting sodium level known as hyponatremia remains a relatively rare killer, the malady is striking more people as more amateur athletes try to slog through marathons, Bean and other doctors said.
A 2005 study found that 13 percent of those tested at the finish line of the Boston marathon suffered from measurable hyponatremia, sometimes called water intoxication.
It occurs when people drink so much water that they dilute the sodium levels in their blood. Brain cells are particularly hard hit by the salt imbalance, causing dangerous swelling that can hamper blood flow to the brain, said Dr. John S. Rose, an associate professor of emergency medicine at UC Davis Medical School.
Some athletes have ended up in emergency rooms with seizures, and a few have died, including two well-publicized deaths in 2002 that spurred a rethinking about how much endurance athletes should drink.
General guidelines suggesting so much fluid per hour have been scrapped as outdated or are considered almost too controversial to offer, said Bean. The problem is that each sport, each person and each circumstance differs.
A high school athlete playing football in a Sacramento heat wave should still err on the side of drinking plenty of water, because in team sports, dangerous heat illnesses and dehydration are far more common than water intoxication, Bean said.
But an amateur athlete who runs a slow marathon, taking more than four hours, should ignore the once-standard advice to "stay ahead of your thirst."
People who plug away slowly at marathons, triathlons and other endurance sports for hour after hour are especially at risk for swigging down much more water than their bodies need.
For them, said Bean, the guidelines should be: "Drink when you're thirsty. Don't drink just to drink. Don't try to stay ahead of your thirst. Don't stop and drink every mile."
There also may be little protection in switching from plain water to sports drinks fortified with electrolytes and glucose.
The 2005 study of marathoners, published in the New England Journal of Medicine, found equal levels of hyponatremia among runners who drank water and those who used sports drinks.
Most at risk were those who took longer to run the race; stopped for liquid every mile; drank more than 3 liters of fluid (about four-fifths of a gallon) during the race; or were much fatter or much slimmer than average marathoners, said Bean. There's been speculation that women are more likely to suffer from too much water, but there's no firm evidence that it's gender-related, she said.
The danger still isn't understood as broadly as it could be among endurance athletes, said Jeff Landauer, a Roseville massage therapist who in November won the grueling Ultraman World Championship in Hawaii.
"You definitely hear about it (hyponatremia), but it's more the exception than the rule out there," said Landauer. "They're always preaching, 'Make sure you're getting enough fluids.' "
Landauer, 39, who ran a double marathon, bicycled 261 miles and swam 6.2 miles to take the Ultraman title, urged athletes to pay attention to their fluid needs during training to help gauge what's right for them.
One difficulty for athletes is that many symptoms of dehydration and over-hydration are the same: cramping, fatigue, headaches, nausea and more. The person with too much water, though, will also have swelling, perhaps looking visibly puffy or weighing more at the race's end than at the beginning.
On Friday, 28-year-old Jennifer Lea Strange of Rancho Cordova died after trying to win a video game system for her children in a contest run by radio station KDND (107.9 FM). Another contestant said Monday that Strange had consumed 224 ounces of water in about three hours. The Sacramento County Coroner's Office has attributed her death to apparent water intoxication, although a final determination of cause of death could take several months.
Along with endurance athletes, excess fluids can also be dangerous for infants who are bottle-fed too much water or for children or adults suffering from a serious bout of gastrointestinal disease, said Rose.
For people with very bad stomach bugs, he said, diluted fruit juice may be a better choice for replacing lost fluid than more water, which could further disrupt electrolyte balances.
About the writer:
The Bee's Carrie Peyton Dahlberg can be reached at (916) 321-1086 or [email protected]. Bee staff writer Christina Jewett contributed to this report.
link to article here
(http://www.sacbee.com/296/story/108285.html)
Contrary to earlier thinking, excess fluid intake puts athletes at risk.
By Carrie Peyton Dahlberg - Bee Staff Writer
Last Updated 1:12 am PST Tuesday, January 16, 2007
Story appeared in METRO section, Page B1
(http://www.sacbee.com/296/story/108285.html#comments_here)The shattering death of a young Rancho Cordova woman after a water-drinking contest Friday underscores a risk that goes beyond stunts and hazing, also claiming unwary marathoners and other endurance athletes.
Even some doctors don't realize that a major shift has taken place in the past few years, changing the mantra from "hydrate, hydrate, hydrate" to "drink when you're thirsty," said Dr. Meredith Bean, a sports medicine specialist at Kaiser Permanente's South Sacramento Medical Center.
While the plummeting sodium level known as hyponatremia remains a relatively rare killer, the malady is striking more people as more amateur athletes try to slog through marathons, Bean and other doctors said.
A 2005 study found that 13 percent of those tested at the finish line of the Boston marathon suffered from measurable hyponatremia, sometimes called water intoxication.
It occurs when people drink so much water that they dilute the sodium levels in their blood. Brain cells are particularly hard hit by the salt imbalance, causing dangerous swelling that can hamper blood flow to the brain, said Dr. John S. Rose, an associate professor of emergency medicine at UC Davis Medical School.
Some athletes have ended up in emergency rooms with seizures, and a few have died, including two well-publicized deaths in 2002 that spurred a rethinking about how much endurance athletes should drink.
General guidelines suggesting so much fluid per hour have been scrapped as outdated or are considered almost too controversial to offer, said Bean. The problem is that each sport, each person and each circumstance differs.
A high school athlete playing football in a Sacramento heat wave should still err on the side of drinking plenty of water, because in team sports, dangerous heat illnesses and dehydration are far more common than water intoxication, Bean said.
But an amateur athlete who runs a slow marathon, taking more than four hours, should ignore the once-standard advice to "stay ahead of your thirst."
People who plug away slowly at marathons, triathlons and other endurance sports for hour after hour are especially at risk for swigging down much more water than their bodies need.
For them, said Bean, the guidelines should be: "Drink when you're thirsty. Don't drink just to drink. Don't try to stay ahead of your thirst. Don't stop and drink every mile."
There also may be little protection in switching from plain water to sports drinks fortified with electrolytes and glucose.
The 2005 study of marathoners, published in the New England Journal of Medicine, found equal levels of hyponatremia among runners who drank water and those who used sports drinks.
Most at risk were those who took longer to run the race; stopped for liquid every mile; drank more than 3 liters of fluid (about four-fifths of a gallon) during the race; or were much fatter or much slimmer than average marathoners, said Bean. There's been speculation that women are more likely to suffer from too much water, but there's no firm evidence that it's gender-related, she said.
The danger still isn't understood as broadly as it could be among endurance athletes, said Jeff Landauer, a Roseville massage therapist who in November won the grueling Ultraman World Championship in Hawaii.
"You definitely hear about it (hyponatremia), but it's more the exception than the rule out there," said Landauer. "They're always preaching, 'Make sure you're getting enough fluids.' "
Landauer, 39, who ran a double marathon, bicycled 261 miles and swam 6.2 miles to take the Ultraman title, urged athletes to pay attention to their fluid needs during training to help gauge what's right for them.
One difficulty for athletes is that many symptoms of dehydration and over-hydration are the same: cramping, fatigue, headaches, nausea and more. The person with too much water, though, will also have swelling, perhaps looking visibly puffy or weighing more at the race's end than at the beginning.
On Friday, 28-year-old Jennifer Lea Strange of Rancho Cordova died after trying to win a video game system for her children in a contest run by radio station KDND (107.9 FM). Another contestant said Monday that Strange had consumed 224 ounces of water in about three hours. The Sacramento County Coroner's Office has attributed her death to apparent water intoxication, although a final determination of cause of death could take several months.
Along with endurance athletes, excess fluids can also be dangerous for infants who are bottle-fed too much water or for children or adults suffering from a serious bout of gastrointestinal disease, said Rose.
For people with very bad stomach bugs, he said, diluted fruit juice may be a better choice for replacing lost fluid than more water, which could further disrupt electrolyte balances.
About the writer:
The Bee's Carrie Peyton Dahlberg can be reached at (916) 321-1086 or [email protected]. Bee staff writer Christina Jewett contributed to this report.
link to article here
(http://www.sacbee.com/296/story/108285.html)