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Drink to Your Health

New Views on Fluid Consumption

The hyponatremia issue has forced sports and medical groups to take a new look at their hydration guidelines, and several have already adjusted their recommendations.

Boot camp: The Army has put new recruits through a period of hard physical training since day one, but the first hyponatremia death wasn't reported in the journal Military Medicine until early 1999. Two years later, the same publication brought news of 17 hyponatremia cases in a 2-year span, along with the statement: "The authors conclude that hyponatremia resulted from too aggressive fluid replacement practices for soldiers in training status." The Army's fluid-replacement recommendations have since been lowered.

Marathon medicine: Last fall, the International Marathon Medical Directors Association (IMMDA) issued the first fluid-consumption guidelines from a medical organization completely focused on runners (as opposed to, say, soccer, baseball, or football players). IMMDA, which represents some 150 major marathons on all seven continents, suggests that marathoners should consume 13 to 27 ounces of fluid per hour, with an absolute ceiling at 27 ounces. For more, visit aims-association.org/immda.htm.

That's about half the fluid requirement proposed since 1996 by the widely quoted "Exercise and Fluid Replacement" position stand of the American College of Sports Medicine, which calls for 20 to 40 ounces per hour. For more, visit acsm-msse.org, and click on "Position Stands."

Boston Marathon and USA Track & Field: For the first time in its 107-year history, the Boston Marathon this spring provided all 20,000 runners with a fold-out pamphlet from the American Running Association and the American Medical Athletic Association. It advised runners to stay hydrated but not to overdrink, to maintain a salty diet, to favor sports drinks, and to recognize warning signs. Also at Boston, USATF released its first-ever guidelines, "Proper Hydration for Distance Runners," which recommended that runners weigh themselves before and after long, hard training runs to determine their own unique sweat rate. For more info, visit usatf.org/coaches/library.

A note from our friends at Gatorade: Sure, they're an advertiser. But the thing we like most about Gatorade is the company's long commitment to supporting research and education efforts on topics relating to fitness, nutrition, and health. The Gatorade Sports Science Institute (gssiweb.com) has recently published one of the most comprehensive advisories on hyponatremia, "Hyponatremia in Athletes." Here you'll find everything from the possible effects of a recessive Cystic Fibrosis gene to a section on metabolic water production while running. Mostly, the folks at Gatorade want you to know that proper hydration is important, and that you're an experiment of one. That is, each of us sweats at a different rate, produces varying amounts of sodium in our sweat, and reacts differently to heat stress.

 

 

 


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