Athletes' best bet is to only drink when thirsty

Previous athletic guidelines suggested drinking 8 ounces of water for every 20 minutes of exercise.

By Stephen Feller

WASHINGTON, June 29 (UPI) -- New guidelines from an international panel of experts on sports-related health suggest that the best bet for athletes concerned about dehydration is to drink when they are thirsty, lest they over-hydrate their bodies and develop a condition called exercise-associated hyponatremia, or EAH.

EAH occurs when drinking too much overwhelms the kidney's abilty to excrete the excess water and sodium in the body becomes diluted, causing cells to swell, which can be life-threatening. The greater threat than dehydration, researchers said, is over-hydration.


"The risks associated with dehydration are small," Dr. James Winger, a sports medicine physician at Loyola University Medical Center, said in a press release. "No one has died on sports fields from dehydration, and the adverse effects of mild dehydration are questionable. But athletes, on rare occasions, have died from overhydration."

Winger was one of several experts to gather at the 2015 CrossFit Conference on Exercise-Associated Hyponatremia in Carlsbad, Calif., in February to revamp guidelines on sports-related hydration concerns.

"Using the innate thirst mechanism to guide fluid consumption is a strategy that should limit drinking in excess and developing hyponatremia while providing sufficient fluid to prevent excessive dehydration," the researchers wrote in the new guidelines. Because an athlete can afford to lose 3 percent or so of body weight due to water loss during competition, slight dehydration should not affect athletic performance.


Hydration guidelines have long been based on consuming about 8 ounces of water every 20 minutes while exercising, and many athletes are pushed by coaches to drink more fluids to avoid dehydration, as well as muscle cramps and heat stroke. Neither cramps nor heat stroke are caused by dehydration, according to Winger.

"The evidence is firm that every single death from exercise-associated hyponatremia is avoidable," Dr. Tamara Hew-Butler, an associate professor of exercise science at Oakland University, said in a press release. "We can consciously control the amount of fluid that enters our body and must reconsider, re-educate and reinforce appropriate fluid intake and intravenous fluid guidelines."

The study is published in the Clinical Journal of Sports Medicine.

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