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Old 03-05-2014, 11:41 AM   #131
Russell Greene
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Great find, Chris.

Even if athletes were wise enough to ignore "the maximal amount that can be tolerated" and focus on drinking to replace "body weight loss," that still would create hyponatremia.

For one, how will a competitor know when he's finally replaced all body weight lost and needs to stop drinking? Are we to assume that the athlete has tracked their sweat, urine, and drinking in mL throughout the race? Or that they practiced their hydration in an environment that perfectly mirrored the race environment?

Furthermore, hyponatremia has occurred in athletes who lost small amounts of body weight while exercising.

Neither "the maximal amount that can be tolerated," nor "sufficient to replace all the water lost through sweating" are safe drinking recommendations.

And, as bad as the 1996 ACSM recommendations were, Gatorade's ads were worse: (link is W/F safe)

Originally Posted by Christopher Morris View Post
I also found on their website this summary of hyponatremia: (wfs)

Under the section "WHAT FLUID-REPLACEMENT GUIDELINES SHOULD ATHLETES FOLLOW?" they say none of the position stands say that athletes should drink as much as possible. Then they quote four associations, including the ACSM that states, in their quote, that athletes should "consume the maximal amount that can be tolerated." After these four quotes they again state that "none suggests that athletes 'drink as much fluid as possible during exercise.'"

Huh? Holy crap. This semantics is killing people, and they see a difference between "drink as much as possible," and "consume the maximal amount"?
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Old 03-05-2014, 11:54 AM   #132
Clint Harris
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Thanks Dale, that was nice and clear.

Does HQ have any plans on what they are going to do ? Other than in here?

Are you planning on rattling the ACSM's cage? Have already done so ? Banning these drinks from the games? Adding this to a new lecture?

Is it just Gatorade and the fault here? What about other big soda companies that did nothing to argue against this "science". They are benefiting from people drinking more too, so may well have clammed shut.
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Old 03-05-2014, 01:57 PM   #133
Dale F. Saran
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Clint - we've had discussions with several of the largest law firms in the world on the subject. We're not an aggrieved party, so to speak, regarding GatorAde deaths. We lack "standing" in legal parlance, as we are not (for example) a relative of Dr. Lucero - or any of the other dozen or so who were killed by excessive drinking during endurance events.

I think at this point our goal is first to let our cousins in the endurance community know what's up. We've probably ruffled their feathers a bit over the years, by either pointing out that excessive endurance work had muscle-wasting consequences (a fact that even the greats in their field had openly discussed in the 80's, but it's always less palatable coming from outsiders), or by challenging endurance as the fitness paradigm (see Coach's minor shot at Outside magazine's pick for fittest man back in "What is Fitness?"), but notwithstanding, we still feel obligated to try to educate them and keep them from dying by excessive hydration - as per what were considered "industry" (ACSM) guidelines, derived from "science." Noakes and Speedy all but eliminated hyponatremia in their countries by simply restricting the frequency of those water stations that are unbiquitous at Marathons. You don't need to drink every freaking mile; you didn't lose anything worthy of consideration in the 10 minutes between one station and the next one a mile away.

We'll start there. ACSM will have to answer both in court - both a real one and the court of public opinion - for their part in trumpeting science that hurts people. Maybe people will start to see them for what they really are and stop pointing to every wonky academic paper or alleged "study" that proves one ACSM claim or another - and start asking (a) about the merits of the paper rather than pointing to its "peer reviewed-ness" - which their 1996 guidelines certainly were - and (b) daring to ask "qui bono?"
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Old 03-05-2014, 07:44 PM   #134
Russell Berger
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Another source of evidence regarding Gatorade’s continued negative influence on hydration guidelines can be seen in the publications of the Academy of Nutrition and Dietetics. AND receives sponsorship funding from Gatorade’s parent company, PepsiCo (source WFS). Regarding hydration for baseball, the AND suggests players:
“Stay well hydrated by drinking about 4 to 8 ounces of fluid every 15 minutes. Don't rely on thirst to alert you about when you should drink since at that point dehydration is already setting in. Instead, use sports bottles with ounces clearly marked to keep the right hydration pace through the game.”
The average baseball game lasts 2.5 hours. This means the AND is recommending 16-32 oz. (473-946ml) of “fluid” per hour, or 40-80 ounces (1183-2366 ml) of fluid over the course of the average game. This is on par with what is suggested for competitive endurance athletes, who are expending energy continuously hour after hour, clearly a serious exaggeration of the hydration needs of athletes engaged in a game that produces roughly 18 minutes of action (WFS). What’s worse is the AND’s continuation of the deadly mantra that athletes should drink even when they aren’t thirsty- a mantra begotten from the shoddy science of the ACSM. But it gets better:
“Start with water but then after about 1 hour of playing and sweating switch to a sport drink. Sports drinks provide electrolytes such as sodium that are lost in sweat and also carbohydrates to replenish muscle energy.”
Unfortunately, when a Harvard study of Boston marathon runners found that 13% had some degree of hyponatremia, it turned out that the condition was just as likely to happen among those who drank sports drinks during the marathon as it was among those who chose water (source WFS). It is also documented that Cynthia Lucero consumed “large amounts of Gatorade” before her death in the 2002 Boston marathon (source WFS). On the AND’s website, there is also a section titled “training for a marathon?” On this page, the AND offers an exaggerated version of the “dehydration harms performance” claim, here suggesting that poor performance results from 2% dehydration, not dehydration greater than 2%. Their motive becomes transparent in the next paragraph:
“ sure to check which sport beverage will be available on the marathon course. You may want to carry your own flavor or brand or have someone offer you your brand on the route. Don't find out at mile 13 that you hate the sport beverage the race offers."
In short, the AND is another example of an authoritative organization in the field of health and fitness who is taking big soda’s sponsorship money and publishing erroneous and potentially deadly hydration recommendations in exchange. Is the AND just clueless about hyponatremia? Apparently not, as they have made their position on hyponatremia prevention clear:
“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.” (source WFS)

I believe that Gatorade’s financial influence here is obvious. Rather than admitting their mistakes and educating the public about the dangers of consuming large amounts of Gatorade, they would rather spend money to have academic puppets paint their product as necessary for preventing the very condition it has been shown to cause.
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Old 03-05-2014, 09:19 PM   #135
Shane Scott
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Hi Lynne!

If there are any copies of Waterlogged left, I would love to read one!

Thank you!

on the list! ~Lynne
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Old 03-06-2014, 11:16 AM   #136
Preston Sprimont
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Interesting topic, glad it has been brought up here for discussion.

It seems pretty evident that Gatorade and its partners have botched the science to better peddle their product. And unfortunately, this is about par for the course in corporate sponsorship and in marketing. I'm interested to see how this will play out over time, and if/how the knowledge will disseminate beyond discussion boards like this. Gatorade is huge, and, as others have mentioned, pretty ubiquitous in all kinds of sports at both professional and amateur levels. That ubiquity/popularity will be tough to trump.

Lynne, if still available, I'd love a copy of the book. Please and thank you.

on the list! ~Lynne
Heart, Mind, and Swole
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Old 03-06-2014, 01:04 PM   #137
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

As recently as 2009, the ACSM, the American Dietetic Association, and the Dietitians of Canada in a joint position paper, on page 718, included the following...."hyponatremia (serum sodium concentration less than 130mmol/L) can result from prolonged, heavy sweating with failure to replace sodium, or excessive water intake".

There's never been any evidence to support the claim that prolonged or heavy sweating can produce EAH. Scientific evidence supports only the claim that excessive water intake can produces EAH.

So the ACSM's response to the EAH deaths that followed from their hyperhydration campaign was to continue to distort the scientific record and hydration science, again, we have to conclude, to support their "platinum sponsor", Gatorade.

It's telling that in backpedalling from the "drink all that can be tolerated" recommendation we find not guidelines that propose MAXIMUMS but reduced minimums and more "abnormal science" as the British Journal of Sports Medicine called it. prevention of what are these minimums being offered? To date nothing adverse has been demonstrated in under drinking during athletic competitions yet at least a dozen deaths and thousands of injuries have resulted from over drinking. I see the ACSM's serial perversion of the scientific record on the subject of hydration, and specifically EAH and electrolyte consumption, coupled with a failure to offer not maximums but reduced minimums as compelling evidence that the ACSM has surrendered any presumed or claimed scientific authority. The parallels to big tobacco and it's "scientists" and "science" are remarkable. The ACSM has become a shill for big soda.

Last edited by Coach : 03-06-2014 at 01:11 PM. Reason: replace "and" with "yet"
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Old 03-06-2014, 02:48 PM   #138
Dave Rubin
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM


I'd love a copy if there are any left!

on the list! ~Lynne

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
Robert D Taylor Jr
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William J Mallon
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Old 03-06-2014, 07:56 PM   #139
Chris Russell
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Not sure if there are any books left, but I would be overcome with joy of I could get a copy...Hook me up!


on the list! ~Lynne
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Old 03-06-2014, 08:08 PM   #140
Sean Rockett
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Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

Lynne, I will take a book. Thank you, Sean Rockett.

on the list! ~Lynne
Sean Rockett, MD
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