Pre-race characteristics and race performance in hyponatremic and normonatremic finishers of Czech ultra-races

Chlíbková, Daniela; Rosemann, Thomas; Knechtle, Beat; Sengeis, Marietta; Posh, Lenka; Tomášková, Ivana

doi:10.5507/ag.2016.013

Cited by 4 publications

(7 citation statements)

References 26 publications

(58 reference statements)

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“…Sex split not reported Plasma sodium, incidence of EAH Cohort study Low Overall EAH incidence was 6%. No sex differences in incidence of EAH Rust et al[ 59 ] 46 athletes (19 females and 27 males) who completed a 100 km ultramarathon Body mass, plasma and urinary electrolytes, Hct, plasma volume, fluid, energy, and electrolyte intake Cohort study Low 5% (n = 1) of females and 11% of males (n = 3) developed EAH. Significant decrease in Hct in females (-1.2%, p > 0.05) but not in males (-1.1%, p < 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…Of the twelve studies examining illness and injury incurred as a direct result of running, eleven measured rates over one event, and one looked at injury incidence across 12 months (Table 7) [52][53][54][55][56][57][58][59][60][61][62][63]. There was no difference in the overall rate of exercise-related injuries across a 12-month period; however, female athletes suffered a disproportionate number of stress fractures [52].…”

Section: Training or Race-related Illness And Injurymentioning

confidence: 99%

“…Six studies investigated sex differences in sodium and fluid balance during ultramarathons [58][59][60][61][62][63]. Despite females having a higher water intake in one study, and a significant decrease in haematocrit in another, no statistically significant differences in hyponatraemia incidence were found [58][59][60][61][62][63].…”

Section: Training or Race-related Illness And Injurymentioning

confidence: 99%

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Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review

Kelly

2023

Sports Med - Open

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Background There is evidence of sex differences in the physiology of endurance exercise, yet most of the advice and guidelines on training, racing, nutrition, and recovery for ultramarathons are based on research that has largely excluded female athletes. The objective was therefore to review the current knowledge of sex differences in ultramarathon runners and determine if sufficient evidence exists for providing separate guidelines for males and females. Methods This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three databases were searched for studies investigating differences in elite and recreational male and female ultramarathon runners. Studies were included if they compared males and females and looked at outcomes relating to the performance or health of ultramarathon runners. The quality of the included studies was determined using the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach. Results The search strategy identified 45 studies that met the inclusion criteria. Most studies were observational in design, with only three papers based on randomised controlled trials. The overall quality of the evidence was low. Sex differences in the predictors of ultramarathon performance; physiological responses to training, racing, and recovery; chronic and acute health issues; and pacing strategies were found. There were areas with contradictory findings, and very few studies examined specific interventions. Conclusion The results from this review suggest that the development of sex-specific guidelines for ultramarathon coaches and athletes could have a significant effect on the performance and health of female runners. At present, there is insufficient high-quality evidence on which to formulate these guidelines, and further research is required.

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Section: Resultsmentioning

confidence: 99%

Section: Training or Race-related Illness And Injurymentioning

confidence: 99%

Section: Training or Race-related Illness And Injurymentioning

confidence: 99%

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Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review

Kelly

2023

Sports Med - Open

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“…Thirteen finishers (12%) were found to have mild post-race EAH (plasma [Na + ] ranging between 129 and 134 mmol/L) (Chlíbková et al, 2016b ), corresponding to 16% runners and 10% mountain bikers. No differences in pre-race characteristics, such as age, sex and pre-race experience, were observed among the participants in all types of races; the groups were homogeneous (Chlíbková et al, 2016a ). The number of years of active running/biking, number of similar completed races, total training hours per week and the number of running/biking hours per week ( n = 138) are listed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Reported Hydration Beliefs and Behaviors without Effect on Plasma Sodium in Endurance Athletes

Chlíbková

Nikolaidis²,

Rosemann

et al. 2017

Front. Physiol.

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Purpose: Little information is available on the association of hydration beliefs and behaviors in endurance athletes and exercise-associated hyponatremia (EAH). The aim of the present study was to determine hydration beliefs and behaviors in endurance athletes.Method: A 100 and 38 recreational athletes [107 mountain bikers (MTBers) and 31 runners] competing in seven different endurance and ultra-endurance races completed pre- and post-race questionnaires, and a subgroup of 113 (82%) participants (82 MTBers and 31 runners) also provided their blood samples.Result: More than half of the participants had some pre-race (59%), mid-race (58%), and post-race (55%) drinking plan. However, the participants simultaneously reported that temperature (66%), thirst (52%), and plan (37%) affected their drinking behavior during the race. More experienced (years of active sport: p = 0.002; number of completed races: p < 0.026) and trained (p = 0.024) athletes with better race performance (p = 0.026) showed a more profound knowledge of EAH, nevertheless, this did not influence their planned hydration, reported fluid intake, or post-race plasma sodium. Thirteen (12%) hyponatremic participants did not differ in their hydration beliefs, race behaviors, or reported fluid intake from those without post-race EAH. Compared to MTBers, runners more often reported knowledge of the volumes of drinks offered at fluid stations (p < 0.001) and information on how much to drink pre-race (p < 0.001), yet this was not associated with having a drinking plan (p > 0.05). MTBers with hydration information planned more than other MTBers (p = 0.004). In comparison with runners, more MTBers reported riding with their own fluids (p < 0.001) and planning to drink at fluid stations (p = 0.003). On the whole, hydration information was positively associated with hydration planning (n = 138) (p = 0.003); nevertheless, the actual reported fluid intake did not differ between the group with and without hydration information, or with and without a pre-race drinking plan (p > 0.05).Conclusion: In summary, hydration beliefs and behaviors in the endurance athletes do not appear to affect the development of asymptomatic EAH.

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“…While the prevalence of EAH in the Western States Endurance Run held in California was at around 16% [153] to 30% [56], the prevalence of EAH did not exceed 11% in ultra-marathons held in Switzerland [126,131,132,149,150,170]. In endurance events held in the Czech Republic, the prevalence of EAH was very low [134,192,193,194]. In the 113 recreational athletes, the prevalence of EAH was 11.5%, with all athletes presenting only mild hyponatremia [134].…”

Section: The Prevalence Of Exercise-associated Hyponatremia (Eah) mentioning

confidence: 99%

Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review

et al. 2019

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Exercise-associated hyponatremia (EAH) is defined as a plasma sodium concentration of <135 mmol/L during or after endurance and ultra-endurance performance and was first described by Timothy Noakes when observed in ultra-marathoners competing in the Comrades Marathon in South Africa in the mid-1980s. It is well-established that a decrease in plasma sodium concentration <135 mmol/L occurs with excessive fluid intake. Clinically, a mild hyponatremia will lead to no or very unspecific symptoms. A pronounced hyponatremia (<120 mmol/L) will lead to central nervous symptoms due to cerebral edema, and respiratory failure can lead to death when plasma sodium concentration reaches values of <110–115 mmol/L. The objective of this narrative review is to present new findings about the aspects of sex, race location, sports discipline, and length of performance. The prevalence of EAH depends on the duration of an endurance performance (i.e., low in marathon running, high to very high in ultra-marathon running), the sports discipline (i.e., rather rare in cycling, more frequent in running and triathlon, and very frequent in swimming), sex (i.e., increased in women with several reported deaths), the ambient temperature (i.e., very high in hot temperatures) and the country where competition takes place (i.e., very common in the USA, very little in Europe, practically never in Africa, Asia, and Oceania). A possible explanation for the increased prevalence of EAH in women could be the so-called Varon–Ayus syndrome with severe hyponatremia, lung and cerebral edema, which was first observed in marathon runners. Regarding the race location, races in Europe seemed to be held under rather moderate conditions whereas races held in the USA were often performed under thermally stressing conditions (i.e., greater heat or greater cold).

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Pre-race characteristics and race performance in hyponatremic and normonatremic finishers of Czech ultra-races

Cited by 4 publications

References 26 publications

Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review

Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review

Reported Hydration Beliefs and Behaviors without Effect on Plasma Sodium in Endurance Athletes

Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review

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