Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM

[Coach]

For years I've been challenging the exercise science community to name a single contribution coming from academia that has changed the way any athlete or coach trained for a sport.

In 2003, on this message-board, I repeated the challenge.
http://board.crossfit.com/showthread...5322#post15322

It turns out I'd not been paying enough attention to academic sports sciences to catch a major development.

Throughout the 1990's the American College of Sports Medicine, the Gatorade Sports Science Institute, and Gatorade published peer reviewed literature that recommended that athletes drink as much as 40 ounces of water, or better yet a sports drink, for each hour they exercised, or "consume the maximum amount that can be tolerated".

The American College of Sports Medicine and their "Platinum Sponsor," their only platinum sponsor, Gatorade, systematically debased thermoregulatory science, and subsequently hydration science, in order to promote Gatorade. The consequences of this were the deaths of at least a dozen people, and serious injury to thousands others. I believe that the Gatorade/ACSM cabal also has the distinction of having adversely affected sporting performance on a level the world has never seen before, and profit is and remains the singular motive.

The mechanism by which these deaths and injuries occur is "exercise associated hyponatremia" and "exercise associated hyponatremic encephalopathy." The cause of these deaths was pure and simple over drinking promoted by Gatorade and the ACSM.

It's time to drive Big Soda out of fitness and by extension, the health sciences.

On the upside, I missed another important contribution, this one not deadly but lifesaving. Dr. Timothy Noakes, MD, DSc has tirelessly led the battle against the Gatorade/ACSM alliance and their deadly corruption of sport and health science for nearly twenty years. Dr. Noakes' book "Waterlogged" is a brilliant and courageous accounting of this unbelievable story and a major contribution to training and sport science. I salute him.

[Luke Sirakos]

Down with hydration?

[Mike Doehla]

I always thought drinking Gatorade during workouts were great for you. Plus I love Michael Jordan so I can't quit.

[Jason Kelley]

There was a study (quite recent) that used athletes and rehydrated them by IV so they could not 'taste' what they were 'drinking'.

Those who just got water performed as well as those who got some fancy electrolyte concoction.

[Christopher Morris]

Originally Posted by Jason Kelley

There was a study (quite recent) that used athletes and rehydrated them by IV so they could not 'taste' what they were 'drinking'.

Those who just got water performed as well as those who got some fancy electrolyte concoction.

I'm guessing this study was for relatively short exercise? Hyponatremia is a risk if you're exercise for long periods and overhydrating (for example, a marathon runner).

The point Coach is trying to make is that overhydration is dangerous, whether with water or Gatorade.

A Google search of "Gatorade hyponatremia" is pretty interesting.

[Dakota Base]

Originally Posted by Coach

Throughout the 1990's the American College of Sports Medicine, the Gatorade Sports Science Institute, and Gatorade published peer reviewed literature that recommended that athletes drink as much as 40 ounces of water, or better yet a sports drink, for each hour they exercised, or "consume the maximum amount that can be tolerated".

...pure and simple over drinking promoted by Gatorade and the ACSM.

...Dr. Noakes' book "Waterlogged" is a brilliant and courageous accounting of this unbelievable story and a major contribution to training and sport science.

Pulled out a few snippets of your post to focus in on those points.

This is a gap where I think Crossfit is being somewhat intentionally ignorant. While the "crosstraining revolution" (decades old, NOT attributed to Crossfit) was a major advance in sports fitness, we're not the only players in the game, and we can learn things from our "specialized" comrades.

While I've been crosstraining for 20yrs, I also supplemented with running and cycling. About 5yrs ago, I dipped my toe into the realm of becoming "serious about endurance," so I studied and asked questions. This was one of those questions. I grew up with coaches touting the "you're dehydrated by the time you feel thirsty" and "take in as much as your gut can stand" lines, and I felt like crap during long runs over 8miles, or bike rides over 30mi. One of my coaches suggested gatorade over water, another recommended salt tabs, both with the idea of replacing electrolytes. But then I finally realized, my coaches were only as good as the information they had in hand.

Controlled/limited water/carb intake during exercise is something that has been well known to endurance athletes for a long time. I can't say when it started, but I CAN say it was well established at least 5yrs ago when I started to "convert" over to endurance. As described in Dr. Noakes book, around 20oz per hour is the maximal absorption rate for men, half of the recommendation you cited as Gatorade's claims. If this post marks the introduction of this information to the Crossfit community, then boy, I gotta say, we're WAY behind. Maybe it's time we start paying more attention to how the other half lives?

Now, granted, comparing something learned a decade ago with something learned 30yrs ago isn't necessarily fair. Maybe 10yrs from now we'll find out that the proper number is 30oz instead of 20oz or 40oz, just like we learned more about cholesterol, eggs, carbs (adkins, paleo, zone, etc), and on and on. I'm not in that loop well enough to know whether "big soda" as you call it is refuting how much water should be consumed per hour or whether they've accepted the new discoveries. Frankly, I just spent an hour looking for any REAL science on the Gatorade.com website, and didn't really find any. While that's disheartening because they claim to be a science based product, on the other hand, they're not making claims through their site as if they are standing on the 40oz/hour recommendation.

What I DO think is misleading, if anyone remembers 5-10yrs ago, there used to be a silhouette of a guy on the gatorade bottle, pouring a drink into his mouth, and there were "K+" and "Mg+" hexagons pouring in. The idea is that Gatorade replenishes your depleted electrolytes with potassium and magnesium salts (with Mg being popular at that time due to the "sea salt" fad). Great news, as that would be safer than sodium salts, but the bad news is that if you look at the nutrition label, there wasn't actually any magnesium in it. Maybe it was just a marketing screw up (since marketing and graphics design folks aren't often the ones formulating products), maybe it was intentionally misleading, that I can't say.

Simplest answer is to know what you're drinking, and why you're drinking it. I don't have a beef with "big soda" because nobody asked Pepsi to provide a health food product, they asked for a drink that tastes good. I don't have a beef with McDonald's because nobody asked them to provide healthy double quarter pounders. Consumers drive product development and marketing strategies. People want more, whether it's more taste, bigger servings, more savings, more options, you name it. Nobody forced half of Americans to become overweight, they chose to eat that way. I'd argue that a VAST majority of the annual Gatorade consumption each year isn't by someone actively training, or fueling or recovering therefrom. People drink it for the taste, and for the image. That's their baggage, and they have to deal with the consequences, just like they have to deal with the consequences of drinking beer over dinner, or deal with the consequences of not getting enough fiber in their diet. Overdo it with Gatorade, you'll have issues, just like if you overdo it with beer.

[Dakota Base]

Originally Posted by Christopher Morris

I'm guessing this study was for relatively short exercise? Hyponatremia is a risk if you're exercise for long periods and overhydrating (for example, a marathon runner).

Don't get caught up in extremes. It can happen much easier than most people realize.

I spent enough time (debatably too much time) at the gym in college that I caught most of the "going's on" through osmosis. When a girl went down on the treadmill one morning while I was there. I talked about it later with the manager. She commented that the girl went down from hyponatremia, and that girls go down every year, usually in the spring semester, right after new years. They're on crash diets and suddenly burst into exercise that their body isn't used to, and only drinking water. They all had their cute pink waterbottles and had read online they needed to drink a half gallon a day or more of water.

Boom, electrolyte shortage. Granted they have malnutrition issues coming soon enough behind it, hopefully they'd give up their diet before that happened, but sometimes they didn't.

These girls aren't marathoners, they're just jogging 30min a day on a treadmill and not feeding their bodies properly, and unfortunately hydrating properly becomes a bad thing.

[Christopher Morris]

Originally Posted by Dakota Base

What I DO think is misleading, if anyone remembers 5-10yrs ago, there used to be a silhouette of a guy on the gatorade bottle, pouring a drink into his mouth, and there were "K+" and "Mg+" hexagons pouring in.

Simplest answer is to know what you're drinking, and why you're drinking it. I don't have a beef with "big soda" because nobody asked Pepsi to provide a health food product, they asked for a drink that tastes good.

Gatorade has marketed itself and provided "research" to place itself as an electrolyte replacement. This thread is questioning whether it serves a benefit as it claims, i.e., we're debating the "why you're drinking it."

I stopped drinking Gatorade years ago when I noticed the first ingredients are water and sugar. That tells me it is made for taste primarily.

[Jeff Enge]

Originally Posted by Christopher Morris

I stopped drinking Gatorade years ago when I noticed the first ingredients are water and sugar. That tells me it is made for taste primarily.

That's why I started adding it back in actually. Easily drinkable intra-workout carbs that are taste-compatible with my BCAAs.

[Christopher Morris]

Originally Posted by Jeff Enge

taste-compatible with my BCAAs.

"Taste-compatible" - that's a good word. I think a true electrolyte replacement would taste like sweat.