Statement of the 3rd International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015

Hew‐Butler, Tamara; Rosner, Mitchell H.; Fowkes-Godek, Sandra; Dugas, Jonathan P.; Hoffman, Martin D.; Lewis, Douglas; Maughan, Ronald J.; Miller, Kevin; Montain, Scott J.; Rehrer, Nancy J.; Roberts, William O.; Rogers, Ian R.; Siegel, Arthur J.; Stuempfle, Kristin J.; Winger, James; Verbalis, Joseph G.

doi:10.1136/bjsports-2015-095004

Cited by 87 publications

(102 citation statements)

References 183 publications

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“…Indeed, participants who had an exercise‐induced body mass loss of >2% and a plasma osmolality >300 mOsmol/kg showed higher average circulating endotoxin concentrations compared with those who maintained euhydration with ad libitum water intake during 2 hours running at 60% VO 2max in hot ambient condition (34°C) . Attention must also be given to avoid over‐hydration during exercise, considering exercise‐associated hyponatraemia has been linked to gastrointestinal symptoms, particularly nausea and regurgitation . It therefore appears that starting exercise euhydrated and maintaining euhydration throughout attenuates various components of exercise‐induced gastrointestinal syndrome.…”

Section: Prevention Strategiesmentioning

confidence: 99%

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Costa

Snipe

Kitic

et al. 2017

Aliment Pharmacol Ther

286

426

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Summary Background “Exercise‐induced gastrointestinal syndrome” refers to disturbances of gastrointestinal integrity and function that are common features of strenuous exercise. Aim To systematically review the literature to establish the impact of acute exercise on markers of gastrointestinal integrity and function in healthy populations and those with chronic gastrointestinal conditions. Methods Search literature using five databases (PubMed, EBSCO, Web of Science, SPORTSdiscus, and Ovid Medline) to review publications that focused on the impact of acute exercise on markers of gastrointestinal injury, permeability, endotoxaemia, motility and malabsorption in healthy populations and populations with gastrointestinal diseases/disorders. Results As exercise intensity and duration increases, there is considerable evidence for increases in indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. The addition of heat stress and running mode appears to exacerbate these markers of gastrointestinal disturbance. Exercise stress of ≥2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest, irrespective of fitness status. Gastrointestinal symptoms, referable to upper‐ and lower‐gastrointestinal tract, are common and a limiting factor in prolonged strenuous exercise. While there is evidence for health benefits of moderate exercise in patients with inflammatory bowel disease or functional gastrointestinal disorders, the safety of more strenuous exercise has not been established. Conclusions Strenuous exercise has a major reversible impact on gastrointestinal integrity and function of healthy populations. The safety and health implications of prolonged strenuous exercise in patients with chronic gastrointestinal diseases/disorders, while hypothetically worrying, has not been elucidated and requires further investigation.

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Section: Prevention Strategiesmentioning

confidence: 99%

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Costa

Snipe

Kitic

et al. 2017

Aliment Pharmacol Ther

286

426

View full text Add to dashboard Cite

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“…Recentní konsensuální zpráva z konference věnované hyponatremii ve sportu označila za klíčový etiologický faktor rozvoje zatížením indukované hyponatremie právě excesivní příjem tekutin a nárůst tělesné hmotnosti po skončení zatížení. Příjem tekutin řízený pocitem žízně je vnímán jako základní nástroj prevence hyponatremie (Hew-Butler et al, 2015). Manifestace hyponatremie v době rozmachu masových běžeckých závodů na různé vzdálenosti a zejména při účasti běžců rekreační úrovně (městské běhy, horské maratony, ultramaratony atd.)…”

Section: Autonomní Příjem Tekutin a Vytrvalostní Výkonunclassified

Příjem tekutin během vytrvalostního zatížení – pít podle pocitu žízně, ano nebo ne?

Kumstát

2019

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AbstraktPři nedostatečném příjmu tekutin, při nadměrných ztrátách vody z těla pocením nebo kombinací obou faktorů dochází u sportovců k dehydrataci. Individuálně řízený příjem tekutin během zatížení založený na znalostech míry pocení je optimální strategií, která umožnuje sportovcům kontrolovat rozsah dehydratace a minimalizuje negativní dopady na sportovní výkon. Současná doporučení jsou však soudobou literaturou podrobena kritice pro přeceňování nežádoucích účinků dehydratace na sportovní výkon. "Benevolentní" strategie příjmu t ekutin během sportovního zatížení regulovaná diktátem žízně prochází renesancí a je podložena dostupnou literaturou. Cílem teoretického sdělení je kritická diskuse dvou kontrastních strategií příjmu tekutin během vytrvalostního zatížení, jejich dopad na rozvoj dehydratace a výkon sportovce. Východiskem diskuse jsou recentní publikace k tématu autonomního a předpisovaného příjmu tekutin ve sportu. Na základě dostupné literatury je možné autonomní model příjmu tekutin považovat za hydratační strategii bránící nežádoucímu vzestupu tělesné hmotnosti během zatížení v délce trvání do 90 min. Autonomní příjem je využitelný zejména u rekreačních sportovních aktivit. Předpisovaný příjem tekutin by měli preferovat především účastníci vytrvalostních závodů s délkou trvání nad 90 min a při vysoké okolní teplotě (>30 °C), dále vrcholoví sportovci během pravidelného vícefázového tréninku. AbstractIn case of insufficient fluid intake, excessive water loss from the body by sweating or a combination of both factors results in dehydration in athletes. Individually controlled fluid intake during exercise based on the knowledge of sweating rate is an optimal strategy that allows athletes to control the extent of dehydration and minimises the negative impact on sports performance. However, current recommendations are criticised by contemporary literature due to the overestimation of the undesirable effects of dehydration on sports performance. The "benevolent" strategy of fluid intake during an exercise, regulated by the dictate of thirst, is being re-evaluated with evidence-based support in the available scientific literature. The theoretical work aims to critically discuss two contrasting strategies of fluid intake during endurance exercise, their impact on the progression of dehydration and on athlete's performance. Recent publications on the topic of autonomous and prescribed fluid intake in the sport were the background for the discussion. Based on the current literature, autonomous drinking behaviour is recommended to majority of athletes participating in an exercise with a duration of < 90 min as it sufficiently prevents from overdrinking. Prescribed drinking regime should be adopted by endurance athletes in hot environments (> 30 °C) when exercise duration exceeds 90 min and by an elite athlete during daily multiple-session training.

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“…Exercise associated hyponatremia (EAH) is a potentially life-threatening condition that can happen in athletic endurance events lasting more than four hours. EAH is defined as a serum sodium concentration of less than 135 mmol/L during or up to 24 h after prolonged physical activity [3,4] and is mainly caused by excessive sodium loss via sweating and/or excessive drinking of hypotonic fluids [5]. A high incidence of EAH has been documented mainly in ultra-endurance sports events but also in sports of shorter duration such as marathon [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…A high incidence of EAH has been documented mainly in ultra-endurance sports events but also in sports of shorter duration such as marathon [6][7][8][9][10]. Exercise-associate hyponatremia has been observed among marathon runners, cyclists, triathlon athletes, and recreational runners, participating most commonly in endurance events [3,4]. Data from studies carried out at the London and Boston Marathons indicate that EAH occurs in 10-15% of sampled marathon finishers [6,8,11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exercise-Associated Hyponatremia during the Olympus Marathon Ultra-Endurance Trail Run

et al. 2020

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Research on hyponatremia during mountain marathons is scarce. The present study aimed to investigate the prevalence of exercise-associated hyponatremia during a 44-km trail running race that reached an altitude of 2780 m (Olympus Marathon). Sixty-two runners (five women) who completed the race participated in the study (age: 34.4 ± 8.6 years; height: 1.77 ± 0.06 m; and weight: 75.3 ± 10.0 kg). Anthropometric characteristics, blood, and urine samples were collected pre- and post-race. Food and fluid intake were recorded at each checkpoint. Due to race regulations, the runners could not carry any additional food and fluids besides the ones provided at specific checkpoints. Five runners (8%) exhibited asymptomatic hyponatremia (serum sodium <135 mmol∙L−1). Serum sodium in the hyponatremic runners decreased from 138.4 ± 0.9 (pre) to 131.4 ± 5.0 mmol∙L−1 (post), p < 0.05. Plasma osmolality increased only in the eunatremic runners (pre: 290 ± 3; post: 295 ± 6 mmol∙kg−1; p < 0.05). Plasma volume decreased more in the hyponatremic compared to eunatremic runners (−4.4 ± 2.0 vs. −3.2 ± 1.4%, p < 0.05). Lastly, dietary sodium intake was lower in the hyponatremic runners compared to eunatremic (789 ± 813 vs. 906 ± 672 mg; p < 0.05). The incidence of hyponatremia among the athletes was relatively low, possibly due to race conditions.

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Statement of the 3rd International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015

Cited by 87 publications

References 183 publications

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Příjem tekutin během vytrvalostního zatížení – pít podle pocitu žízně, ano nebo ne?

Exercise-Associated Hyponatremia during the Olympus Marathon Ultra-Endurance Trail Run

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