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-   -   Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM (http://board.crossfit.com/showthread.php?t=86218)

Russell Greene 08-25-2014 11:18 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Quote:

Originally Posted by Darryl Shaw (Post 1240589)
While I am happy to support any campaign that highlights the risks of over-hydration it must be evidence based if it is to be taken seriously. Therefore, using this childs death to further this campaign before the cause of death has been established is simply indefensible, and I hope 'The Russells' have the decency to either edit their blog or remove that post until after the autopsy results are known.

Darryl,

Having spoken to both the Oliver family and Dr. Sandra Godek, the cause of death is clear. Consider that I have access to more information than what you've read in the press.

Tighe Crovetti 08-25-2014 12:37 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Reiterating my request to get a copy of the book, if there are any left. Thanks!

Russell Greene 08-25-2014 03:03 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Another high school football player, Walker Wilbanks, passed away today from swelling of the brain after collapsing in practice. All signs point to EAHE.

http://www.clarionledger.com/story/n...medium=twitter

(link is W/f safe)

Christopher Morris 08-25-2014 09:32 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Each death reported that could be overhydration EAHE feels like a sucker punch to the stomach. I hope those connected to the victims will search and learn more about overhydration. How many more will die before good information gets ahead of the problem? I would love to see Gatorade do an appropriate use campaign like Tylenol or smoking companies have done. Until then, keep expounding, Russels.

Quote:

I'm interested in going back to the ACSM/GSSI studies on heat exhaustion, etc. to see why they recommended excessive drinking in the first place.
Quote:

Originally Posted by Christopher Morris (Post 1220965)
Dale,
Thank you for those last two posts. The timeline you present is insightful as to who knew what and when. That has clarified why CrossFit HQ wants to take this issue head-on so aggressively.

I've had questions about the origin of hydration science since this topic was brought up. In Waterlogged, pages 148-154 summarize the invention of Gatorade from an authoritative source. Though it is claimed Gatorade was born from research, the circumstances do not stand up to scientific scrutiny in the least. The book summarizes: "Dr. Cade's presumption is that the explanation for the success of a college football team can be reduced to a single variable, in this case to the presence of additional electrolytes in their sports drink. In reality, the factors determining success in professional team sports are so complex that they defy analysis." The rise of Gatorade feels less scientific than sports superstition, almost on the level of Mark Spitz's mustache. (wfs)

Coach 08-26-2014 12:38 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I found both of these articles important on the subject of EAHE:

The Clinical Journal of the American Society of Nephrologists, 2007, "Exercise Associated Hyponatremia", offers a compelling overview of EAHE reaching the damning conclusion that "In many respects, EAH can be viewed as an iatrogenic condition because of the prevailing view that exercising athletes should drink as much fluid as tolerable during a race."
http://cjasn.asnjournals.org/content/2/1/151.full


From 2004, The British Journal of Sports Medicine, "Weight Changes, Medical Complications, and Performance during an Iron Man Triathlon", demonstrating that "there is no increased risk of heat illness associated with high levels of dehydration, and that high levels of weight loss do not significantly influence performance."
http://bjsm.bmj.com/content/38/6/718.full#ref-8

Russell Greene 08-28-2014 04:12 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Jacob Levin sent me this hyponatremia story from his time in the Army. One wonders how many other cases of fatal and near-fatal EAHE are yet to be recorded in the literature. A nephrologist told me yesterday that everyone knows at least one person who's suffered from EAHE. The full number of both incidents and fatalities may be many times what Noakes found in Waterlogged.

"In 2011, I was an IET soldier at Fort Benning, Georgia. On a twelve-mile road march, in order to prevent becoming a 'heat casualty,' I consumed roughly eight liters of water. I note that this is an estimate, based on how much water my Camelbak could store. I'd also been drinking water throughout the day to pre-hydrate for the march.

At roughly Mile 10, I became disoriented, confused, dizzy, and nauseated. Thanks to the excellence of my cadre, I was identified and set aside and an ambulance was called.

To make a long story short, when I was delivered to the ER, my core temperature was slightly elevated (101), but not enough to cause my symptoms. I was, however, severely overhydrated.

If the US Army is supposed to be issuing 'maximums' rather than 'minimums'" then my otherwise-excellent trainers failed me. We routinely were told to drain canteens and then turn them upside down to prove we'd drank it all ...

I almost died, and I know of other guys (again, anecdotal rather than hard-fact) who were hospitalized with almost identical symptoms."

Brian Chontosh 09-08-2014 11:07 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I've been patiently waiting and just settling into passive monitoring of this process to ask for an accounting. Maybe I am just restless in the moment.

Maybe I am tired now as specifically Football Season is upon us; youth, collegiate, professional, and I'm not altogether satisfied any real action or change is taking place. My son and daughter (likely yours as well) have started lacrosse season and I see it. 'Hydrate Hydrate Hydrate.'

How many more people are going to die before the scare becomes realized real? Because it is real.

It's been since January 1st that I've refused all forms of Sports Drinks and specifically Gatorade. I've made it through the heat of the year and accomplished a few pretty lofty physical events; just fine I might add. I do my best to keep it out of the hands of my children and loved ones. I educate my 'people around me' the best I can as well.

We proffer proud chests and words over social media and leverage social pressures to get informed. But Beverage Powders and the 'Hydrate Mantra' exist no less than they did 8 months ago. Much worse - the common misconceptions and 'understanding' of hydration science is still being taught in our military and athletic communities.

If the ALS Ice Bucket Challenge can raise 110$ million (94 in the last <2 months) how can we not create at least a national petition or public boycott on products?

40,000+ views and 206 comments since Feb 19th. If Gatorade sales are up this quarter, we are failing.

I'm in. This is maybe a Call for Action before we become guilty of the reluctance to act and the 'powder keg kicking' that the ACSM Guidelines have done over the past decade and (no)change.

Mike Doehla 09-08-2014 12:47 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I may have missed something but are people really thinking Gatorade is killing kids. Or is there more to this. I know over hydration is a real thing but is there a difference if it's Gatorade or water?

Chris Meldrum 09-08-2014 02:21 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Understand that I am late to this party...but I bounced over here from the Message Board discussion of this from 140907.

I would love a copy of the book if there are any still available. Thanks in advance!

on the list! ~Lynne

Jacob Levin 09-08-2014 02:48 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Mike,

If I understand the issue correctly, it's not necessarily that over-use of Gatorade is more dangerous than overhydration in general. The issue is that Gatorade has, for a number of years, deliberately downplayed and outright lied about the risks of EAHE in order to sell their product.

I'm not an expert on the subject, so take my explanation with a grain of salt.

Mike Doehla 09-09-2014 01:42 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Quote:

Originally Posted by Jacob Levin (Post 1241624)
Mike,

If I understand the issue correctly, it's not necessarily that over-use of Gatorade is more dangerous than overhydration in general. The issue is that Gatorade has, for a number of years, deliberately downplayed and outright lied about the risks of EAHE in order to sell their product.

I'm not an expert on the subject, so take my explanation with a grain of salt.

Gotcha. I wasn't sure what the story was here. Thanks.

Blair Robert Lowe 12-20-2014 05:59 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
http://youtu.be/mu9VA3pTEzs

WFS

*Bump*

Russell Greene 01-13-2015 03:16 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
On February 20 we are hosting The 2015 CrossFit Conference on Exercise-Associated Hyponatremia, organized by the HEAT Institute.

You can register for the event here: https://www.regonline.com/builder/si...ventID=1658120 (w/f safe)

The speaker list includes Harvard and Georgetown Medical School faculty as well as hydration consultants for the military, NFL, and NBA. If you're interested in fitness and live anywhere near San Diego, CA, this will be a useful conference for you. There is no charge for attending.

Christopher Morris 02-26-2015 01:34 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
http://library.crossfit.com/free/pdf...2_Achauer2.pdf

This article is a recap of the 2015 CrossFit Conference on Exercise-Associated Hyponatremia.

I thought this point was interesting: "Drinking glass after glass of water while sedentary generally doesn’t have negative health implications. It mostly leads to more trips to the bathroom. The problem begins when someone drinks excessively while exercising," typically slow to moderate endurance exercise.

Russell Greene 03-18-2015 03:44 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Thanks for sharing that link, Christopher.

You can watch the full video of the 2015 CrossFit Conference on Exercise-Associated Hyponatremia here:

https://www.youtube.com/watch?v=4GizAYJfuH4 (w/f safe)

The scientists who presented are also working on a joint statement that they'll publish in scientific journals.

One of the highlights was Dr. Kevin Miller's presentation on cramps, starting at 4:06:43: https://www.youtube.com/watch?v=4GizAYJfuH4&t=14803

Dr. Miller critically analyzed the work of Gatorade advertiser (and lead CHAMP author!) Dr. Michael Bergeron on cramping.

The Gatorade advertiser, Bergeron, propounds the theory that electrolyte loss causes cramps. His theory is based off of an unproven assumption.

According to Dr. Miller, "technically, no one has ever shown that crampers lose more sodium in their sweat than non-crampers."

This relates to hyponatremia indirectly. Athletes believe that drinking commercial sports drinks like Gatorade will prevent cramps. To compound the problem, athletes are largely unaware of the risks of hyponatremia.

For example, Zyrees Oliver suffered intense cramping during summer football training last year. Doctors and coaches advised him to hydrate frequently to treat his symptoms. Zyrees complied, drank gallons of Gatorade, and died from exercise-associated hyponatremic encephalopathy (EAHE).

Zyrees died a thoroughly preventable death.

Luke Sirakos 03-18-2015 04:58 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I'm not sure any sane person would recommend consuming 4 gallons of liquids. I don't even know how you drink 4 gallons of anything.

Russell Greene 05-04-2015 12:50 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Gatorade has finally relented and begun advising athletes to drink "ad libitum," or "to thirst."

And ACSM's incoming president Larry Armstrong admitted that Gatorade funding "does affect objectivity."

Christopher Morris 05-05-2015 08:42 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Russ,
Your link isn't working for me, but I figure it's from your blog:
http://therussells.crossfit.com/2015...n-confessions/ (wfs)

You call on Larry Armstrong to "use his authority at ACSM to remove Gatorade’s corrosive impact. He must not just end Gatorade’s partnership with ACSM, but also ban all ACSM fellows from accepting Gatorade dollars." A hopeful idea, as you quote him saying that Gatorade funding affects the objectivity of hydration research.

Not so hopeful when I read this, as he seems unwilling to stand up to his funded peers:

Quote:

To Larry Armstrong, professor of environment and exercise physiology at the University of Connecticut and one of the few sports scientists not on the payroll of Gatorade, the new research is highly suspect. "I believe the vast majority of people do not exceed 50 minutes (of exercise), so I would think the vast majority of people who use Gatorade don't need it," he says.

But Dr. Armstrong adds that he is reluctant to press the point for fear of offending his academic peers. "I have too many friends that deal with them," he says. "It's not necessarily a bad thing, but it does affect objectivity."

Russell Greene 05-06-2015 07:58 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Thank you for the link, Chris.

Russell Greene 06-29-2015 07:25 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Here is the joint statement from the conference that CrossFit sponsored:

"Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015"

http://journals.lww.com/cjsportsmed/...ational.2.aspx

(link is w/f safe)

Coach 08-02-2015 09:31 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Ironically, while Gatorade’s Korey Stringer Institute was Tweeting on the subject of medical services at The CrossFit Games, I was on Capitol Hill speaking to committee staffers about regular injury and death from EAHE arising from the fraudulent and perverted science spawned by collaboration of Gatorade, and its other institute, the Gatorade Sports Science Institute, and their puppet, the American College of Sports Medicine.

Gatorade/GSSI, and the ACSM are individually and collectively unique in that no other organizations or individuals have caused acute and deadly trauma in athletes with health guidelines. You’d need a gun to do what these “fellows” have done with “science”. (Notice, I said acute. More to follow on their contributions to chronic disease. Here you’d need bombs.)

I have three ideas for the Korey Stringer Institute, and their founding partner, Gatorade. (If anyone from the other founding partner is paying attention, then follow my claim that your partner has needlessly hurt athletes.)

1. Why not rename the institute after one of the football players your founder’s guidelines have killed? Zyrees Oliver, Walker Wilbanks, Patrick Allen, ...

2. Promote the statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference sponsored by CrossFit, Inc. This has been published by the Clinical Journal of Sports Medicine and The British Journal of Sports Medicine. What came from that conference was an elegant scientific consensus advising to drink when you’re thirsty and don’t when you’re not. Amazing how much work it took to clean up your mess on this single topic.

3. It’s time to look at the role of hyponatremia-induced intracranial pressure on the transmission and propagation of collision energy in football players. Have tainted hydration guidelines been a cause of traumatic brain injury? Let’s be a real institute and do some real science.

Eager to help,

Greg Glassman, CEO
CrossFit Inc.

Christopher Morris 08-03-2015 01:39 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
You're saying Gatorade has hurt athletes, and now they're saying CrossFit has hurt athletes.

Quote:

Originally Posted by Russell Greene (Post 1252244)

I wondered if this earlier post had the feeling of "we've arrived, and the work is done." I'm glad to see that CrossFit HQ continues to push and educate about overdrinking.

(I'd love to see an ice bucket challenge - similar to the ALS trend last year - to raised awareness on overhydration.)

RE: KSI tweet

Is there cause for concern after injuries at the 2015 Games, or does the T Nation article exaggerate the lack of medical involvement? Are Games organizers considering the implementation of more preventive medicine at future events, or are those injuries within normal limits?

John Drohan 08-10-2015 09:38 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Looks like Coke is on the offensive. No mention of Crossfit per se, but the article looks like standard deflection techniques...

http://well.blogs.nytimes.com/2015/0...ad-diets/?_r=0 (WFS)

Russell Greene 08-12-2015 07:35 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
John,

The article doesn't mention CrossFit, but those organizations and individuals are closely related to the themes in this thread.

Dr. Steven Blair is a former president of the American College of Sports Medicine. And the Exercise is Medicine program that the article mentions was founded by Coke in partnership with the ACSM.

One cornerstone of the Exercise is Medicine program is fitness licensure, which ACSM and friends are lobbying for. As Greg Glassman wrote in another thread,

"Exercise is Medicine is another Coca-Cola initiative that will make it tough—and eventually illegal—to talk about any of this, at least and get paid. When exercise becomes 'medicine,' then pointing out that Coke is poison will be malpractice."

Links above are w/f safe.

Christopher Morris 08-12-2015 10:55 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Quote:

Originally Posted by Christopher Morris (Post 1255648)
Is there cause for concern after injuries at the 2015 Games, or does the T Nation article exaggerate the lack of medical involvement? Are Games organizers considering the implementation of more preventive medicine at future events, or are those injuries within normal limits?

I didn't get an answer to my questions, but I recognize it is a sensitive topic. If you say, "Yes, we're going to make changes to prevent injuries," then critics will say, "Ha! CrossFit admits they hurt people." If you say, "No, we're not making changes," then critics will say, "CrossFit is irresponsible!" I'll just look forward to next year to another great sporting event. I wish you and the athletes another great Games season in 2016.

Michael V. Erickson 07-28-2016 12:01 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
http://www.wyff4.com/news/Drinking-t...chool/40929628

Christopher Morris 07-29-2017 07:49 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
The way of thinking is changing.

From CNN:
http://www.cnn.com/2017/07/21/health...vis/index.html (wfs)

Quote:

Drinking only when thirsty results in better performance than does chugging constantly.
Quote:

If you take in (too) much fluid, sodium levels can become dangerously low. The resulting condition, known as hyponatremia or water intoxication, can cause headaches, vomiting, confusion, seizures and, in some cases, death.
Previously, hyponatremia occurred mainly in slower marathon runners, but it's now showing up among people engaged in activities such as hiking, half-marathons and hot yoga.
Quote:

Striving for pale pee could prompt some people to drink too much, overhydrate themselves and develop hyponatremia.
Also, I was at a week-long boy scout camp this week. Spending a week outdoors can cause dehydration. I walked past one group where the counselors were telling the scouts that they don't have to drink, drink, drink - that they should drink when they are thirsty.


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