Hydrate and die

New York Times May 6, 2003 New Advice to Runners: Don't Drink the Water By GINA KOLATA

Every athlete, every fitness enthusiast has heard the advice to drink plenty of water. Drink as much
as you can. Don't wait until you are thirsty. By then it may be too late. You may be seriously
dehydrated, risking dizziness, collapse, even death. "Stay ahead of your thirst," athletes and
would-be athletes are told.

But now USA Track & Field, the national governing body for track and field, long-distance running
and race walking, says that advice is wrong. In what it calls a major revision of its guidelines,
the organization says endurance athletes, who may be consuming huge amounts of water over the course
of a long event, may risk seizures, respiratory failure and even death from drinking too much.

Instead of drinking as much as they can, the new guidelines say, runners should drink when they are
thirsty. People in long races like marathons may want to weigh themselves before and after long
practice runs to see how much they lose from sweating and drink that amount when they race, and no
more. The guidelines are at www.usatf.org.

Dr. David E. Martin, an exercise physiologist at Georgia State University in Atlanta, called the
change revolutionary and overdue. He is a co-author of a new advisory statement on fluid
replacement in marathons written for the International Marathon Medical Directors Association.
It was a supporting statement for the track and field advisory.

Ds. Martin said the old advice was leading to water gorging, with people stopping at every water
stop, downing water cups and so diluting their blood that their sodium levels plummeted, a
condition known as hyponatremia.

The problem occurs in any endurance event that gives people the time to drink and drink and drink.
It emerges among people who hike the Grand Canyon, in those who compete in Ironman Triathlons and,
most notably, in marathons.

Hyponatremia is not a problem for elite marathon runners, Dr. Martin said, because they go too fast
to drink too much. "Running at a five-minutes-per-mile pace," he said, "there's no way you can drink
enough to get hyponatremia."

Those runners, he added, have their own water stations, the elite water stops, where they have their
own sports drinks that they have chosen in advance.

Instead, Dr. Martin said, the problem is with slower runners, who may take as long as nine hours to
run a race. They may be running with groups of friends, raising money for a favorite charity. Or
they may be tourist runners, people who plan vacations around marathons.

"We're worried about this increasingly large group of people, taking courses in how to run a
marathon, going to shoe shops to learn how to run," Dr. Martin said. "What has been told to them is
the party line. Make sure you drink. You can't drink too much. Carry water with you or you will get
dehydrated. Don't worry about heat, just drink more. That's wrong. It's wrong, wrong, wrong."

What about the risks of dehydration, leading to heatstroke as the body temperature soars? Grossly
exaggerated, medical experts say. Most athletes who collapse at the finish line suffer from postural
hypotension, a drop in blood pressure when blood pools in the legs, and not from heatstroke.

Examining information on illnesses in marathons since 1985, Dr. Martin and Dr. Tim Noakes of the
University in Cape Town in South Africa, write in the advisory statement, "It has been difficult to
find any studies in which dehydration has been identified as the sole important causative factor in
even a single case of exercise-related heatstroke."

But they reported that they found 70 cases of severe hyponatremia.

Many start the race overhydrated, having fallen for what Dr. Heinz Valtin, a physiologist at
Dartmouth Medical College, deems a medical myth: that dehydration is always lurking and must be
fended off with more or less constant sipping of water.

In a paper published in November in The American Journal of Physiology, he said he could find no
scientific support for the common advice for healthy adults to drink at least eight glasses of water
a day and that the benefits that have been claimed - weight loss, relief of constipation, less
fatigue, increased alertness and so on - have no foundation in rigorous studies. "In my opinion, the
vast majority of healthy people do not need that much water," he said.

Dt. Martin agreed, saying: "People have been carrying bottles of water with them. Some people
actually get water intoxication syndrome. They feel lethargic from drinking too much. I worry
about the sanity of those people."

--

Richard Ney

Richard Ney <rtn@pobox.com> wrote:
: New York Times May 6, 2003 New Advice to Runners: Don't Drink the Water By GINA KOLATA

This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in a
Google search for over 21,000 hits.

I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes up
from time to time in this very newsgroup and has had a fair run. To see it framed as the latest news
is evidence of the sensational nature of the popular press.

It seems one would have to really work hard at drinking water to develop water toxicity/hypnotremia,
so, for most of us it's a non-issue. Just use common sense with hydration and nutrition.

Cheerz, Lynzz

Lindsay Rowlands writes:

>> New Advice to Runners: Don't Drink the Water By GINA KOLATA
>
> This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in a
> Google search for over 21,000 hits.
>
> I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes
> up from time to time in this very newsgroup and has had a fair run. To see it framed as the latest
> news is evidence of the sensational nature of the popular press.
>
> It seems one would have to really work hard at drinking water to develop water
> toxicity/hypnotremia, so, for most of us it's a non-issue. Just use common sense with hydration
> and nutrition.

Is that right? Last I recall, there was a lot of hand-wringing in this NG about not getting enough
water while biking. But perhaps I'm not the wreck-bike devotee that you are.

Lindsay Rowlands writes:

> This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in a
> Google search for over 21,000 hits.

> I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes
> up from time to time in this very newsgroup and has had a fair run. To see it framed as the latest
> news is evidence of the sensational nature of the popular press.

Regardless of what your not trying to be, your perspective has not been supported by contributors to
this subject here on wreck.bike. We hear endless testimonials of what proper hydration requires and
it isn't what this report presents in the least. Color of urine is a favorite indicator rather than
thirst or dry mouth.

> It seems one would have to really work hard at drinking water to develop water
> toxicity/hypnotremia, so, for most of us it's a non-issue. Just use common sense with hydration
> and nutrition.

Just the same, Camelbak drives this subject and the number of people riding with warm water bottle
on their backs growing algae is enormous. If you are well versed on the matter, where have you
been lurking?

Jobst Brandt jobst.brandt@stanfordalumni.org Palo Alto CA

Richard Ney <rtn@pobox.com> wrote:
: Lindsay Rowlands writes:

:>> New Advice to Runners: Don't Drink the Water By GINA KOLATA
:>
:> This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in
:> a Google search for over 21,000 hits.
:>
:> I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes
:> up from time to time in this very newsgroup and has had a fair run. To see it framed as the
:> latest news is evidence of the sensational nature of the popular press.
:>
:> It seems one would have to really work hard at drinking water to develop water
:> toxicity/hypnotremia, so, for most of us it's a non-issue. Just use common sense with hydration
:> and nutrition.

: Is that right? Last I recall, there was a lot of hand-wringing in this NG about not getting enough
: water while biking. But perhaps I'm not the wreck-bike devotee that you are.

Now, now. Let's not stoop to name calling. ;-)

Please don't be so reactive. I was just trying to avert panic and a feeding frenzy, but if that's
what people want do, don't let me stop 'em.

Cheerz, Lynzz

jobst.brandt@stanfordalumni.org wrote:

: Just the same, Camelbak drives this subject and the number of people riding with warm water bottle
: on their backs growing algae is enormous. If you are well versed on the matter, where have you
: been lurking?

As I said, the subject has been around for a while. Where have you been?

Let the games begin...

But wouldn't you rather be appropriately informed before panicking about drinking too much water?
Enter 'hypnotremia' in a Google search for many nights of riveting reading.

If you feel I've missed a vital aspect of the research so that I should be concerned about dropping
dead from swigging too much and too often, please let me know. Then again, it may be too late - I
was thinking about having drink of water right now.

Salute! Goodbye cruel world...

Cheerz, Lynzz

Richard Ney wrote:
> Lindsay Rowlands writes:
>
>
>>>New Advice to Runners: Don't Drink the Water By GINA KOLATA
>>
>>This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in a
>>Google search for over 21,000 hits.
>>
>>I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes
>>up from time to time in this very newsgroup and has had a fair run. To see it framed as the latest
>>news is evidence of the sensational nature of the popular press.
>>
>>It seems one would have to really work hard at drinking water to develop water
>>toxicity/hypnotremia, so, for most of us it's a non-issue. Just use common sense with hydration
>>and nutrition.
>
>
> Is that right? Last I recall, there was a lot of hand-wringing in this NG about not getting enough
> water while biking. But perhaps I'm not the wreck-bike devotee that you are.
>

From what I've read, this article misses a key point (probably in order to be sensational).
Hypnotremia is caused by dilution -- if you drink replentishing liquids instead of water alone, you
don't have this problem.

I *believe* that lots of studies have been done that support that energy levels are related to how
dehydrated you are and that once you're behind, you can't typically catch-up unless you decrease the
pace (take a rest). I've seen both of these in my own experience when I do more than an hour or 2 of
riding on a hot day. AND, I find that I can't rehydrate on water alone -- it just doesn't satisfy my
thirst after a quart or so, which is why I carry water in my hydration pak and gatoraide in bottles
on the frame.

These factors have been discussed in this group lots of times, with many opinions on what
replentishing liquid to carry on the frame .

AND *I personally* had a fellow rider have a dehydration related stroke because he didn't drink
enough water on a hot day. This is what his cardiologist told him and what the emergency room
doctors told him. It's 3 years later and he's still paralized on one side, can't talk intelligibly,
and can't ride any more. Every so often, he used to go out on a tandem with his next door neighbor,
but I haven't seen him do this in a while.

David

Lindsay Rowlands <lrowland@metz.une.edu.au> wrote in message
news:<b9a3lv$u60$1@gruvel.une.edu.au>...

> But wouldn't you rather be appropriately informed before panicking about drinking too much water?
> Enter 'hypnotremia' in a Google search for many nights of riveting reading.

Even better, try hyponatremia.

--
Dave...

Dave Kahn <dkahn400@yahoo.co.uk> wrote:
: Lindsay Rowlands <lrowland@metz.une.edu.au> wrote in message
: news:<b9a3lv$u60$1@gruvel.une.edu.au>...

:> But wouldn't you rather be appropriately informed before panicking about drinking too much water?
:> Enter 'hypnotremia' in a Google search for many nights of riveting reading.

: Even better, try hyponatremia.

Oops! It's not exactly a word I use regularly and often my fingers type their own versions and
letter patterns.

Cheerz, Lynzz

On 7 May 2003 02:39:03 GMT, Lindsay Rowlands <lrowland@metz.une.edu.au> wrote:

>Richard Ney <rtn@pobox.com> wrote:
>: New York Times May 6, 2003 New Advice to Runners: Don't Drink the Water By GINA KOLATA
>
>
>This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in a
>Google search for over 21,000 hits.
>
>I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic comes
>up from time to time in this very newsgroup and has had a fair run. To see it framed as the latest
>news is evidence of the sensational nature of the popular press.
>
>It seems one would have to really work hard at drinking water to develop water
>toxicity/hypnotremia, so, for most of us it's a non-issue. Just use common sense with hydration and
>nutrition.
>
>Cheerz, Lynzz
>
>
>
I agree that it has been around for a while... but I think it may be one of those things that we
need to have a bit of an over reaction about...

It seems like every year at least one person in the club I ride with does this to themselves...
despite the fact that it is specifically mentioned at least two times in the training program and
once in the medical waiver everyone must sign.

As far as nobody talking about it here... I don't even remember one discussion about hydration, it
is below my radar in a tech group ... (it was only the clever slam at camel back that had my
attention)

"Lindsay Rowlands" <lrowland@metz.une.edu.au> wrote in message

> Oops! It's not exactly a word I use regularly and often my fingers type their own versions and
> letter patterns.

My keyboard dyslexic is too...{;-)

Paul J Pharr

<jobst.brandt@stanfordalumni.org> wrote in message news:nW%ta.11956$JX2.728215@typhoon.sonic.net...
> Lindsay Rowlands writes:
>
> > This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in
> > a Google search for over 21,000 hits.
>
> > I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic
> > comes up from time to time in this very newsgroup and has had a fair run. To see it framed as
> > the latest news is evidence of the sensational nature of the popular press.
>
> Regardless of what your not trying to be, your perspective has not been supported by contributors
> to this subject here on wreck.bike. We hear endless testimonials of what proper hydration requires
> and it isn't what this report presents in the least. Color of urine is a favorite indicator rather
> than thirst or dry mouth.

But I've always had problems checking the colour of my urine while cycling.

My ding-a-ling tends to get caught in the spokes or drag on the ground.

Hawke

Hawke who? writes:

>>> This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in
>>> a Google search for over 21,000 hits.

>>> I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic
>>> comes up from time to time in this very newsgroup and has had a fair run. To see it framed as
>>> the latest news is evidence of the sensational nature of the popular press.

>> Regardless of what your not trying to be, your perspective has not been supported by contributors
>> to this subject here on wreck.bike. We hear endless testimonials of what proper hydration
>> requires and it isn't what this report presents in the least. Color of urine is a favorite
>> indicator rather than thirst or dry mouth.

> But I've always had problems checking the colour of my urine while cycling. My ding-a-ling tends
> to get caught in the spokes or drag on the ground.

Jobst Brandt jobst.brandt@stanfordalumni.org Palo Alto CA

Hawke who? writes:

>>> This certainly isn't news. Knowledge of hypnotremia has been around for a while. Put the term in
>>> a Google search for over 21,000 hits.

>>> I'm not trying to be a knowledge chauvinist in any shape or form. It's just that this topic
>>> comes up from time to time in this very newsgroup and has had a fair run. To see it framed as
>>> the latest news is evidence of the sensational nature of the popular press.

>> Regardless of what your not trying to be, your perspective has not been supported by contributors
>> to this subject here on wreck.bike. We hear endless testimonials of what proper hydration
>> requires and it isn't what this report presents in the least. Color of urine is a favorite
>> indicator rather than thirst or dry mouth.

> But I've always had problems checking the colour of my urine while cycling. My ding-a-ling tends
> to get caught in the spokes or drag on the ground.

Jobst Brandt jobst.brandt@stanfordalumni.org Palo Alto CA

Which is why, on long rides, I not only take energy drinks, but mineral tablets as well (mainly
magnesium, potassium, iron, zinc, Vit. C.)

Sodium I probably get enough from the drinks and food at the stop. Processed foods are notoriously
high in sodium.

May you have the wind at your back. And a really low gear for the hills! Chris

Chris'Z Corner "The Website for the Common Bicyclist": http://www.geocities.com/czcorner