Hydration message needs diluting

waterKeeping hydrated is an accepted part of being healthy for many of us, but recent research suggests that drinking excessive amounts of fluid when exercising might not be so beneficial for our health.

Professor Emergency Medicine Ian Rogers from St John of God Murdoch Hospital says the message to ‘drink, drink, drink’ is a relatively new one and just a generation ago, people only drank when they were thirsty.

“We now see everyone carrying water bottles and sports drinks to meet their assumed fluid quota for the day,” Professor Rogers says.

“Not that long ago, people drank when they felt thirsty, which was just fine.”

For athletes, keeping hydrated is seen as a critical component of performance ability, but when water, sports drinks and other hypotonic fluids are consumed excessively, the kidneys are unable to excrete the excess fluid. This lowers the sodium level which is needed for the organs, particularly the brain, to function properly.

This condition is known as Exercise-Associated Hyponatremia (EAH) and its symptoms include headaches, vomiting and altered mental status such as confusion. In extreme cases, it can lead to seizures and even death.

Although globally rates of EAH are low, it has been reported across a large cross-section of sports and activities. Athletes who have suffered with varying degrees of EAH include triathletes, soldiers, marathon runners, footballers, hikers, rowers, kayakers and Bikram (hot) yoga participants.

In 2013, a participant in the Rottnest Channel Swim was treated for EAH after drinking excessive fluids. She ultimately recovered well, but only after specialist critical care treatment.

Professor Rogers is one of an international panel of experts whose aim is to eliminate deaths associated with EAH.

“These deaths, although rare, can be avoided with education about the dangers of drinking excessively,” Professor Rogers says.

“Drink according to your thirst – your body knows when you need to drink more.”

Professor Rogers was one of seventeen international experts who convened in the USA in 2015 to review the current data and update previous guidelines on EAH. The delegates represented four countries and nine medical and scientific sub-specialties pertaining to athletic training, exercise physiology, sports medicine, water/sodium metabolism and body fluid homeostasis.

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