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

Dale F. Saran 02-25-2014 02:47 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Christopher - I'm on a plane at the moment, so my interwebz are spotty, but if you search the British Journal of Sports Medicine site (and I can't remember now if I was behind a paywall or I got a 30 day trial for free or something), you get this amazing back and forth between Dr. Noakes and the ACSM detractors who are attacking his work in the editorials. It's almost like watching a debate, except in "slow time," but now that we're years past, you can just read through them rapid fire, as Noakes points out the various studies, the hydration science perversion, etc. And then, there's finally the New England Journal of Medicine Publication that basically proves the point Noakes has been making all along, only NOW it's the NEMJ who's weighed in after a study of runners at the Boston Marathon. The ACSM has this kind of half-hearted withdrawal, then "non-argument" ("Of course we agree with the consensus paper...") followed by a claim that we'll still not know how many lives have been saved from heatstroke by [ahem, a certain sugary beverage] the prior hydration "science." When I get home tonight I'll see if I can't find the links to the various papers, then editorials. It's an amazing read, but it's also tragic when you transpose the dates of death and injuries on top of the editorials. The postscript is Noakes pointing out that it took a publication like the NEMJ and a study of Boston Marathon finishers to finally make a difference, as opposed to his and Speedy's work (and others before him) that had already staved off the harm years earlier in New Zealand and South Africa.

Adam Manery 02-25-2014 02:51 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
This thread has certainly gone in an interesting direction, but I am interested in a copy of the book if one is still available Lynne. [COLOR="Blue"][I]on the list - Lynne[/I][/COLOR]

[QUOTE=Lynne Pitts;1220322]To "sweeten the pot" :D 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[/QUOTE]

Christopher Morris 02-25-2014 04:33 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Dale,
I have started looking through the BJSM for articles by Noakes since you referenced it. I'll find the editorial apology eventually. I didn't know if had come from another source.

A list of articles that shows the back and forth of the debate would be helpful, but would involve a lot of legwork (unless you've already made such a list in the lead up to this call out). Otherwise I'll make my way through what I can find.

Brad Allen Jones 02-25-2014 05:08 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Robert D Taylor Jr;1220631]Doc,

That's different than I was taught (at EMT school, TCCC, and by 18D corpsmen). Where did you get that gouge? HM A school? Was that before or after the Take Motrin, Drink water, Change your socks class? ;)

The way I learned it was:
IV

rectal

drink.[/QUOTE]


Robert,

The way we were taught here is that of they able to drink water that is always preferred over getting IV access because, not only did it save you time, it hydrates you better (although IV is obviously preferred if it is severe dehydration or hypovolemic shock). This is what is taught at FMSS... I can't find the reference right now but it was something like 30% of fluid is retained IV and 90% orally (when I confirm this I'll let you know).

Just out of curiosity when did you recieve this training? 18D's obviously know what they are talking about.

Also, if people would change their socks more often they wouldn't have to worry about this overhydrating electrolyte B.S. ;)

Brad Allen Jones 02-25-2014 05:23 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Dale F. Saran;1220862]Crap - never mind. At some point in a thousand posts if you've never once added to the collective efforts there's only one conclusion: trolling.[/QUOTE]

Yes, two of the most helpful people on the boards recently are banned because they disagree with something that the founder posted. Good discussion though.

Robert D Taylor Jr 02-25-2014 07:17 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Brad Allen Jones;1221068]Robert,

The way we were taught here is that of they able to drink water that is always preferred over getting IV access because, not only did it save you time, it hydrates you better (although IV is obviously preferred if it is severe dehydration or hypovolemic shock). This is what is taught at FMSS... I can't find the reference right now but it was something like 30% of fluid is retained IV and 90% orally (when I confirm this I'll let you know).

Just out of curiosity when did you recieve this training? 18D's obviously know what they are talking about.

Also, if people would change their socks more often they wouldn't have to worry about this overhydrating electrolyte B.S. ;)[/QUOTE]

I was an assistant detachment medical rep for a Mark V SOC det at SBT-20 from 98-04. Lots of training with 18Ds there. Admittedly that's a little bit dated information and obviously drinking is always better than letting the hungover SEAL Corpsman try to find your shrunken vein. :)

You're probably right about the socks.

Robert D Taylor Jr 02-25-2014 07:19 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Lynne can I please get a book? Thanks.

[COLOR="Blue"][I]on the list - Lynne[/I][/COLOR]

Brad Allen Jones 02-26-2014 01:28 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Robert D Taylor Jr;1221085]I was an assistant detachment medical rep for a Mark V SOC det at SBT-20 from 98-04. Lots of training with 18Ds there. Admittedly that's a little bit dated information and obviously drinking is always better than letting the hungover SEAL Corpsman try to find your shrunken vein. :)

You're probably right about the socks.[/QUOTE]

Just don't let then do it WHILE drinking!

Brian Mulvaney 02-26-2014 05:57 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Brad Allen Jones;1221072]Yes, two of the most helpful people on the boards recently are banned because they disagree with something that the founder posted.[/QUOTE]

Brad, I've been disagreeing with the founder for over a decade--often vehemently. He's got boundless energy for disagreement: disagreement is an opportunity for debate, discussion and synthesis. Or even an opportunity to simply agree to disagree. Lack of collegiality, however, can and will get you shown the door.

Russell Greene 02-26-2014 10:17 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Here are some sources that may enlighten the debate. I hope commenters will begin to research the matter, instead of asking why CrossFit cares about bad science and unnecessary deaths.

1996: [B]“American College of Sports Medicine position stand. Heat and cold illnesses during distance running.”[/B]
[url]http://www.ncbi.nlm.nih.gov/pubmed/8970149[/url]

This is the Gatorade/ACSM document that recommends drinking "as much as tolerable" during exercise. Note that Cynthia Lucero and the 11 other confirmed EAH kills all must have found their drinking rates tolerable.

2006:
[B]"Case proven: exercise associated hyponatraemia is due to overdrinking. So why did it take 20 years before the original evidence was accepted?"[/B]
[url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564296/[/url]
by Noakes and Speedy
Quote:
"In 1996 the American College of Sports Medicine (ACSM), an organisation whose only two 'platinum' sponsors are Gatorade and the Gatorade Sports Science Institute (GSSI), produced its modified guidelines, which promoted the concept that subjects should drink 'as much as tolerable' during exercise. This was linked to an extensive marketing campaign, directed by the sports drink industry through the GSSI, to promote this novel dogma."

2007:
[B]"Drinking guidelines for exercise: what evidence is there that athletes should drink 'as much as tolerable', "to replace the weight lost during exercise" or 'ad libitum'?"[/B]
[url]http://www.ncbi.nlm.nih.gov/pubmed/17454546/[/url]
Prior to the release of the new Gatorade/ACSM guidelines later that year, Tim Noakes states:
"The most recent (1996) drinking guidelines of the American College of Sports Medicine (ACSM) propose that athletes should drink 'as much as tolerable' during exercise. Since some individuals can tolerate rates of free water ingestion that exceed their rates of free water loss during exercise, this advice has caused some to overdrink leading to water retention, weight gain and, in a few, death from exercise-associated hyponatraemic encephalopathy."

2007:
[B][B]"Manufactured arguments: turning consensus into controversy does not advance science"
[/B][/B][url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658914/#ref1[/url]
Gatorade/ACSM's Billy Murray defends the 1996 position stand.
He says that it does not advocate drinking "as much as tolerable," even though those exact words are found in the text.

2007:
[B]"American College of Sports Medicine position stand. Exercise and fluid replacement."
[/B]
[url]http://www.ncbi.nlm.nih.gov/pubmed/17277604[/url]
Here the Gatorade/ACSM document that finally lowered their drinking recommendations, modifying their 1996 stance. This was 6 years after Cynthia Lucero died, and 26 years after the first death from exercise associated hyponatremic encephalopathy. A bit late.


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