Hydration, Electrolytes, and Running

My cycling friend, Dan T., brought to my attention an article in Mother Jones, an online and print news magazine, which asks the question, “Do Sports Drinks Really Work?”  The article is a discussion of seven articles in the British Medical Journal which discuss the research supposedly supporting sports drink manufacturers’ claims that their products actually improve athletes’ performance.  In the articles, very valid arguments are made that the whole science behind sports drink claims is heavily tainted by the source of funding for the research, the small number of participants enrolled in the studies, the lack of adequate controls, no blind studies, the proprietary nature of the studies, little or no studies showing negative results, and the sources of funding for the journals and societies themselves.

The lead article of the seven, titled “The Truth about Sports Drinks,” is an investigative essay looking at the rise of the sports drink industry, the ownership of the various sports drinks by the giant multinational corporations Coca-Cola, PepsiCo and Glaxo Smith Klein, and the way the have used supposedly scientific research to support their claims that sports drinks are a necessary adjunct to superior athletic performance.  The science comes from institutes owned by the sports drink companies themselves, or from researchers heavily supported by the companies.  Assumptions, such as the major role of maximizing hydration, the claim that thirst lags behind the need for fluid replacement, that water alone is inferior to the sports drinks for achieving hydration, that color of urine is a key indicator of whether one’s hydration is adequate, are all made without good  scientific evidence.  For the article, the writer and staff studied hundreds of articles used by these companies to justify their claims, and found that the “quality of the evidence was so poor that it was impossible to draw firm conclusions about the effects of the sports drink.”  The research and marketing have been taken as proof by many sports medicine physicians, coaches, and everyday athletes, and become a kind of gospel of training and competing.  A major criticism in the article is that the marketing is also directed to teens and children participating in typical school or club sports, contributing to child obesity.

All of us who run marathons, participate in triathlons, engage in long cycling events, or do other endurance sports, have been influenced by this.  Not everyone buys into it.  We are offered either water or a sports drink at most running events, and my personal observation is that about half the runners go with water.  I’ve been offered gels and salt packets at marathons, advised to “make sure to start hydrating at least a day before”, told to drink before I got thirsty, and all sorts of other hydration related advice.  It becomes especially confusing training in the summer, with warm days of high humidity when we sweat so much our socks squish with every step, and we look like we jumped in a lake.  I know I need water, and I even get terrifically thirsty, but knowing what is appropriate fluid replacement, and whether the sports drink claims have any merit at all is not a simple thing.  I would recommend anyone with an interest in this to look at the articles, and see how they examine with the rigor of true, objective scientific investigators the truth about the claims and marketing of the sports drink makers.

Frank
Ref:  BMJ 2012;345:e4737 doi: 10.1136/bmj.e4737 (Published 18 July 2012)

Mother Jones, “Do Sports Drinks Really Work?, All that stuff about replacing electrolytes and so on you’ve been hearing all these years? Not so much.”  By | Mon Jul. 30, 2012 3:00 AM PDT

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