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Old 03-09-2014, 09:45 AM   #151
Russell Berger
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Some personal anecdote on this subject.

While serving in the Army, I regularly experienced periods of difficult labor in extreme heat. Two contrasting experiences stand out in my mind.
The first was during the final phase of Ranger School on Eglin AFB (FL) during the month of July. The heat was oppressive, and the cadre were in full "heat injury" prevention mode. We were instructed to drink profusely, and were given oral rehydration salts (ORS) to mix into our water source. These were considered so critical to our well being that you would be immediately kicked out of the course if you were caught wasting or not using your salts. Perhaps we were given ORS packets to supplement our poor diet (because we were being slowly starved), but my current understanding is that these packets were thought of as a way to avoid hyponatermia in those that were still being told to drink profusely and ahead of thirst.

During the few weeks I spent in the swamps, I remember at least two individuals in my class becoming what we generically referred to as "heat casualties." The first was a medic from battalion, who surely knew better than most the importance of staying hydrated and consuming his ORS packets. What I didn't find strange at the time, and now recognize as telling, was that his symptoms (confusion, disorientation, memory loss) began at sundown, well after the hottest part of the day had passed. Our initial reaction was to provide him with more fluid (something we had witnessed him drinking regularly) and amazingly, we didn't recognize his complete lack of thirst as a sign that his condition had nothing to do with dehydration.
Needless to say, he remained confused and disoriented until taken by the cadre medical team and infused with what I believe was a hypertonic IV solution. This type of "heat injury" was surprisingly common during this time, and at least one student died during the first phase of Ranger school in July under similar conditions.

In the summer of 2007, I had a very different experience with hydration. My platoon flew out of Ramadi one night in June and conducted a raid in a rural area of Norther Iraq. These night missions were typical for us, and lasted a few hours at most. On this particular night, we did not find our target, and the call was made for us to "stay over day" in an attempt to locate him in the small village during the next 24 hour period. This was unusual, and our unit was prepared for a few hours of night operations, not 24 hours of operations in oppressive desert heat.

Amazingly, our early-morning resupply consisted of only a few bottles of water, batteries, and a pallet of pop-tarts. By daylight many of us were out of water and yet these few bottles were meant to suffice for the roughly 40 men on the ground.

The morning and early afternoon saw our squads patrolling the village in the heat, searching for our target. We rationed our fluids as best possible, but by noon almost everyone was out of water. This mean almost no fluids for hours, and most of us had never sweat so much in our lives. The situation was looking bad, so we quit the search and camped out in the original target until we took fire and had to move to a more defensible position. By late afternoon I had never been more thirsty in my life. This was the same heat, and type of work I had experienced many other times in training, but our symptoms were completely different. None of us were confused. None of us had memory loss or disorientation. All of us were just extremely thirsty.
By late afternoon we knew, by our incredible thirst, that things were getting serious. We broke into a small cement shop on the side of the road and stole a few liter size bottles of air-temperature Pepsi imported from Saudi Arabia. I chugged that warm pepsi. It was the most refreshing and delicious thing I have ever tasted. That is what real dehydration does to you.

These two examples, to me, show the difference between the imagined threat of dehydration/heat injury in the presence of ample fluids, and real dehydration caused by insufficient fluid intake. We had no "heat injuries" or casualties of any kind during this mission, and yet in training I constantly experienced a predictable number of casualties from "heat injury" who had access to as much fluid (and electrolyte enhanced fluid) as they could drink.
What Noake's has proposed regarding hydration in his book better explains the evidence from my personal experience than any of the competing theories I have read.

1. Drinking as thirst dictates is not only safer than drinking water "ahead of thirst", but also electrolyte enhanced water.
2. Drinking "ahead of thirst" or to try to prevent any % of dehydration is a dangerous recipe for hyponatremia.
3. And most obvious, the defining symptom of true dehydration is thirst. Incredible, unquenchable thirst.
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Old 03-09-2014, 10:37 AM   #152
Jeff Glassman
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

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Originally Posted by Dakota Base View Post
#22: What I read from this is that you're calling anyone that isn't as passionate about your "war" on so-called "big soda" as yourself uneducated or unintelligent. … As I stated before, know what you're drinking, and why you're drinking it, and assume anyone that profits from information skewed the information in their favor, and assume that anyone that DOESN'T profit from information may have made a mistake.
Part I of II

Good Libertarian-think. Caveat emptor uber alles.

Science Illiteracy: a Postmodern Art

But pitifully few emptors anywhere in the world can caveat. They aren’t equipped to judge scientific claims, including especially two varieties: Madison Avenue science, and science validated by peer review or consensus. Large numbers of PhDs in the physical sciences, and related fields like medicine, lack basic scientific literacy for a simple pair of reasons – their parent’s lacked scientific literacy, and it is not taught in schools.

An exalted science professor was challenged on that point by a colleague at a seminar. The colleague urged, “One can’t teach a subject if he can’t define it!” The revered professor famously answered, "Science is like love — I can't define it, but I know it when I see it." Thus, science, or more precisely the science of science, was, as Post Modern climatologists are wont to say, settled.

Since the end of World War II, academia has taken the easy route. It has left budding scientists to watch, to osmose from examples, to deduce for themselves as the learned professor deduced for himself but was unable to teach. If these pupils stay in the publish-or-perish world of academia, they're on their way to be becoming full fledged Popperians, i.e., Post Modern Scientists, where scientific models don't actually have to work!

Modern Science Wins in the End

But the chickens will come home to roost. Modern Science always gets the last laugh. Even with all prescribed conditions met, the Beautiful Blue Planet refuses actually to warm. Distance runners will, as Dakota Base observes, mistakenly drink to make the prescribed minimums, only to sicken, some to die. This is where reality trumps both Post Modern Science and caveat emptor.

Popperians seem unaware that they are academically cloistered, moles who pop up in papers published (publish: to make public) in doctrinaire scientific journals. From this enclave, Popperians, their associations, and their publishers claim a consensus validating their dogma, ripe to cultivate for fame, for profit, and for power. As Richard Horton, MD, editor of the Lancet, once said in a lucid moment,
Peer review as a reliable technique for assessing the validity of scientific data is surely discredited. ¶ The mistake, of course, is to have thought that peer review was any more than a crude means of discovering the acceptability – not the validity – of a new finding. Editors and scientists alike insist on the pivotal importance of peer review. We portray peer review to the public as a quasi-sacred process that helps to make science our most objective truth teller. But we know that the system of peer review is biased, unjust, unaccountable, incomplete, easily fixed [jiggered, not repaired], often insulting, usually ignorant, occasionally foolish, and frequently wrong. Richard Horton, Editor, The Lancet, London, UK, Med.J.Au, 2/21/00.
The Birth of the Paper Mills of Science

But en route to the consensus, an unnamed, opportunistic law of economics comes into play. It goes something like this: Thirty scientists in a department work alone to produce a qualifying paper every few years or so. Hence every few years, each player one adds one to his publication list for promotions. But look what happens if they put all their names of every paper. Then they get credit for 30 papers every few years! Publishing turns into a consensus-forming paper mill.

Some papers come cheap — write a case report! Or, for those with a little more ambition, run some trials; measure what can be (who knows, you might get lucky and measure something significant!); rationalize the effort as supporting the dogma; condense the measurements in a cocoon of esoteric statistics by including a section called “Statistical Analysis”, including a sampling of Fisher exact tests, Pearson product moment analysis, Student’s t-tests, D’Agostino tests, Wilcoxon rank sum tests, Tukey or Newman-Keuls or Dunnett’s post-hoc tests with a Bonferroni adjustment, n-factor ANOVA; but hold back the data lest someone check the work or, worse, its predictions; put everone’s name on it; and presto! Tenure!

How Score Might Be Kept

Of course, if Dr. Smith actually has a contribution to make, something that conceivably could evolve into the Smith Theory or Smith's Law, Smith is not likely to ante up. The more significant the paper, the smaller the committee. Accordingly, the scientific potential of peer-reviewed papers tends to be inversely proportional to the number of authors. In general, an author should get 1/n2 credit for each publication on his CV, one nth for the number of participants, times another nth for the scientific potential. Has there ever been a notable scientific achievement credited to a committee?

Give Sawka one credit for his solo paper in 1962 titled Physiological consequences of hypohydration: Exercise performance and thermoregulation. And give him 1/64 = 0.016 credit for his 2010 paper Effect of hypohydration and altitude exposure on aerobic exercise performance and acute mountain sickness shared with Castellani JW, Muza SR, Cheuvront SN, Sils IV, Fulco CS, Kenefick RW, and Beidleman BA. Sawka subtotal: 1.016 effective papers.

By the forces of scientific illiteracy, promoted by unionized education, the US has led the Western World in producing a largely vulnerable populace, spawning charlatans and conspiracies that wittingly or not, do public harm and with a religious fervor.

Notions like caveat emptor must yield so as not to condone fraud in a practical society. Caveat emptor is sound advice, in extreme a slogan to weaken the bonds individuals have with trusted sources (in law, confidential relationships), and citizens with their government.

Continued.
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Old 03-09-2014, 11:02 AM   #153
Jeff Glassman
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Quote:
Originally Posted by Dakota Base View Post
#22: What I read from this is that you're calling anyone that isn't as passionate about your "war" on so-called "big soda" as yourself uneducated or unintelligent. … As I stated before, know what you're drinking, and why you're drinking it, and assume anyone that profits from information skewed the information in their favor, and assume that anyone that DOESN'T profit from information may have made a mistake.
Part II of II

By the forces of scientific illiteracy, promoted by unionized education, the US has led the Western World in producing a largely vulnerable demographic of victims, spawning charlatans and conspiracies that wittingly or not, do public harm and with a religious fervor.

Notions like caveat emptor must yield so as not to condone fraud in a practical society. Caveat emptor is sound advice, in extreme a slogan to weaken the bonds individuals have with trusted sources (in law, confidential relationships), and citizens with their government.

Libertarianism Is Like Love

Libertarianism is like both science and love — we can’t define it, but we know it when we see it. The boundary between Libertarianism and anarchy is unclear: down with government; down with regulations and whole batches of laws; down with collectives. Utopia in the By and By. Libertarian, no longer a word from liberty, but a word for freedom or better, license, the right to color outside the lines, to do harm to the unwary. Caveat emptor.

Governments are fragile, e.g., the Kaiser, the Third Reich, the Soviet Union v. 0, Somalia, Ukraine, Chicago often, Phenix City once. Taking down governments might satisfy a Libertarian urge, but the lessons learned are indeed expensive when allowed to fester for the sake of feeding the ideal of isolationism.

And don't forget Free Markets, which in Libertarian lingo means laissez faire, utterly unfettered, and monopolistic. The idea is dangerous and counterproductive, but seductive, all other things being equal. But as usual, the other things are not. Free Markets uniquely maximize prosperity when they have the effect of setting prices through competition. Government by its absence or presence plays the key role in whether a market exists for competition.

The Inevitability of Evil and Its Destruction

Man can't stop bands of outlaws from forming in his midsts, like particles clustering in weightlessness, like viruses finding invisible cracks in armor. Like hydrogen, the unregulated cosmic dust, condensing, spinning, compressing, forming stars, and black holes that pin galaxies and grow until they disintegrate cataclysmically into high-power, low-grade cosmic waste, all bound up by dark energy and dark matter, necessary supernaturals to balance our equations, and which may in the last analysis exist to condense into fresh hydrogen, closing a perpetual cycle.

Too little government promotes defenselessness against inevitable sociopolitical onslaughts, toothless and unable to process the lessons of two World Wars, the Cold War, and an aborted War on Terror, a petri dish for the re-ignition of the Cold War and Islamic terrorism. Al Qadea is on the run, and they're coming this way. We need a leader to sic ‘em on Putin.

In society little ideas grow into cataclysms. Bands of marauders range from simple lefties morphed progressively into Marxists then Communists; Brown Shirts turning into the Third Reich; a spectrum of religious cultists that go nova, like Jim Jones to Jonestown, Marshall Applewhite to Heaven’s Gate, environmentalism restoring the epidemic of malaria, Jeremiah Wright to the disintegration of a presidency and a world of hurt. Active cults today include IPCC academics who morphed climatology into the pseudo sciences of CO2-caused global warming and ACSM/USARIEM professors who turned physiology into Gatorade poisoning.

So we form governments and societies with teeth. We organize to match forces with organizations, to fight fire with fire. We have laws, as we must, against the concerted frauds, as with Bernie Madoff, Dan Rostenkowski, and Charles Ponzi.

How & Why We Fight Back

But for the more cultured, more subtle affronts, as with Jan Hendrick Shoen, Andrew Wakefield, Margaret Mead, Charles Dawson, Pons & Fleishman, Mann & Jones, et al., we have guidelines of scientific principles backed by a code of ethics. We have conflict-of-interest oaths, sometimes written into publishers' policies, sometime averred in published papers, and sometimes not. Formal codes don't ban conflicts of interest, but disinfect with sunlight.

Nonetheless, the ethical standards for financial involvement with research are weak. They proscribe direct payment for research, but ignore the ultimate fungible nature of cash. So Gatorade dollars fall into ACSM's left rear pocket, funding the College's publication of an array of journals, doctrine peer-reviewed for the profession. For the exercise scientist, these controlled journals are the medium for conforming studies that advance academic careers, studies that ACSM condenses into sponsor friendly Position Stands. The cash loop is closed and Gatoraded science flourishes.

Humans generally seem to have an instinct to expose such shenanigans. But when the mischief results in people sickening and dying, the spirit rises to a duty, a moral imperative to do what one can before it gets so bad the government comes to help. We start in this thread with a generous dose of sunshine.
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Old 03-09-2014, 11:32 AM   #154
Kenny Markwardt
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

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Originally Posted by Lynne Pitts View Post
To "sweeten the pot" CrossFit has 500 copies of Noakes' book available to give to interested parties; reply in this thread if you would like one. We'll grab your email from the admin side, so you don't need to post your email publicly, and our team will contact you for the rest of your information.
Requests so far - will keep this updated, so hit me if I miss you.

Joshua J Grenell
Chris Cooper
Christopher Morris
Dakota Base
Andy Shirley
Russel K Olofson
Teena Escobar
Amy Hollingsworth
Jason Donaldson
Alden Hingle
Christopher E Bloom
Jesse Phillips
Barry Stockbrugger
Ryan Kingsbury
Darrel White
Kirez Reynolds
Darby Darrow
MIchael Wuest
Jason David
Kevin Keast
Joey Dussel
Adam Manery
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Rob McBee
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William J Mallon
I would love a copy if there are any still available. Thanks in advance!

on the list! ~Lynne
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Old 03-11-2014, 10:08 AM   #155
Russell Greene
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

The paper "2009 Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance" states:

"hyponatremia (serum sodium concentration less than 130mmol/L) can result from prolonged, heavy sweating with failure to replace sodium, or excessive water intake."

Source: http://www.sportsnutritionworkshop.c...es/53.SPNT.pdf (w/f safe)

This is logically true, but bad science. It clearly displays Gatorade's pernicious influence on hydration guidelines.

Excessive water intake intake can cause hyponatremia (as can excessive Gatorade intake). There is no evidence, however, that "prolonged heavy sweating with failure to replace sodium," absent excessive fluid intake, can cause hyponatremia. That part is baseless.

I can group two statements together with an "or", one accurate and one ridiculous. The entire sentence will still be true, despite one half being false. In logic this is known as a disjunction. The Stanford Encyclopedia of Philosophy states:

"Disjunction is a binary truth-function, the output of which is a sentence true if at least one of the input sentences (disjuncts) is true, and false otherwise."

Source: http://plato.stanford.edu/entries/disjunction/ (w/f safe)

For example, I could accurately state, "ACSM fellow Michael Bergeron is a researcher or a pedophile." Even if he is not a pedophile, the entire sentence holds. Though true, this sentence allows me to insert a false and misleading claim. Through repetition, I can ingrain a connection between Bergeron and pedophilia into your brain.

So, why didn't the researchers just say "hyponatremia (serum sodium concentration less than 130mmol/L) can result from excessive water intake?" Why add the baseless statement? If not evidence, what motivated the authors to associate prolonged sweating with hyponatremia?

PepsiCo, the owner of Gatorade, sponsors the three organizations behind this paper. And, the influence is obvious:

"Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia."

If excessive drinking, and only excessive drinking, causes hyponatremia, then Gatorade can't possibly solve the problem. It can only be part of the problem. Gatorade only gains if people associate prolonged sweating with hyponatremia through influenced hydration guidelines and research.

Gatorade-funded science follows the evidence to the extent that it can support the consumption of Gatorade. Thus, the ACSM's guidelines present Gatorade as the solution to both dehydration and hyponatremia (i.e. overhydration).
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Old 03-12-2014, 09:40 PM   #156
Adam Morden
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

If there are still copies available I would love one - I have probably been over-hydrating for years since in school and the military the drink, and drink more, before you're thirsty mantra was hammered into me.

On the list.... Lynne
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Old 03-13-2014, 06:46 AM   #157
Alex Kowalewski
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

I would like a copy of the book please if there are any left! Great resource as a coach to inform members and athletes!

On the list.... Lynne
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Old 03-13-2014, 11:53 AM   #158
Mike D Lawson
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

I would really appreciate a copy of waterlogged if you guys have any left. Thank you very much!


On the list.... Lynne
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Old 03-13-2014, 12:06 PM   #159
Greg Boyd
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

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Originally Posted by Kenny Markwardt View Post
I would love a copy if there are any still available. Thanks in advance!

on the list! ~Lynne
I'll take a copy if there are any left. Thanks!

On the list.... Lynne
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Old 03-13-2014, 12:08 PM   #160
Gretchen Ross
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Lynne, I would also love a copy of the book if there are copies still available. Thanks!

On the list.... Lynne
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