Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions
IntroductionHyponatremia often occurs during the practice of endurance sports. We evaluated the impact on hyponatremia of the hydration recommendations of the Third International Exercise-Associated Hyponatremia Consensus Development Conference 2015 (3IE-AHCD) during the 2017 Gran Trail de Peñalara...
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2021.781229/full |
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| author | Diego López de Lara Jorge Gabriel Ruiz-Sánchez Martín Cuesta Germán Seara Alfonso Luis Calle-Pascual Miguel Ángel Rubio Herrera Isabelle Runkle Joseph George Verbalis |
| author_facet | Diego López de Lara Jorge Gabriel Ruiz-Sánchez Martín Cuesta Germán Seara Alfonso Luis Calle-Pascual Miguel Ángel Rubio Herrera Isabelle Runkle Joseph George Verbalis |
| author_sort | Diego López de Lara |
| collection | DOAJ |
| description | IntroductionHyponatremia often occurs during the practice of endurance sports. We evaluated the impact on hyponatremia of the hydration recommendations of the Third International Exercise-Associated Hyponatremia Consensus Development Conference 2015 (3IE-AHCD) during the 2017 Gran Trail de Peñalara marathon (GTP) and the Vitoria Gasteiz Ironman triathlon (VGI).MethodsProspective study of GTP and VGI athletes participating in four information sessions in the months prior to the events, to explain that hydration should only be according to their level of thirst, per the recommendations of the 3IE-AHCD. Consenting event finishers were included in final analysis. Pre- and post-race anthropometric and biochemical parameters were compared.ResultsThirty-six GTP (33 male) and 94 VGI (88 male) finishers were evaluated. GTP race median fluid intake was 800 ml/h, with 900 ml/h in the VGI race. 83.3% GTPfin and 77.6% VGIfin remained eunatremic (blood sodium 135–145 mmol/L). Only 1/36 GTP and 1/94 VGI participant finished in hyponatremia, both with a sodium level of 134 mmol/L. Fourteen percent of GTP, and 21.2% of VGI participants finished in hypernatremia, with no increase in race completion times. No participating athlete required medical attention, except for musculoskeletal complaints. Pro-BNP and Copeptin levels rose significantly. Changes in copeptin levels did not correlate with changes in plasma osmolality, nor total body water content in impedance analysis.ConclusionsRecommending that athletes' fluid intake in endurance events be a function of their thirst almost entirely prevented development of hyponatremia, without induction of clinically significant hypernatremia, or a negative repercussion on race completion times. |
| first_indexed | 2024-12-24T13:02:05Z |
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| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-12-24T13:02:05Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Nutrition |
| spelling | doaj.art-ab476e8c3be5484798f484b39a04a8cd2022-12-21T16:54:06ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-02-01810.3389/fnut.2021.781229781229Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman CompetitionsDiego López de Lara0Jorge Gabriel Ruiz-Sánchez1Martín Cuesta2Germán Seara3Alfonso Luis Calle-Pascual4Miguel Ángel Rubio Herrera5Isabelle Runkle6Joseph George Verbalis7Endocrinología Pediátrica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainEndocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainEndocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainHospital Clínico San Carlos, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainEndocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainEndocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainEndocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Biomédica San Carlos (IdISSC), Madrid, SpainGeorgetown University Medical Center, Washington, DC, United StatesIntroductionHyponatremia often occurs during the practice of endurance sports. We evaluated the impact on hyponatremia of the hydration recommendations of the Third International Exercise-Associated Hyponatremia Consensus Development Conference 2015 (3IE-AHCD) during the 2017 Gran Trail de Peñalara marathon (GTP) and the Vitoria Gasteiz Ironman triathlon (VGI).MethodsProspective study of GTP and VGI athletes participating in four information sessions in the months prior to the events, to explain that hydration should only be according to their level of thirst, per the recommendations of the 3IE-AHCD. Consenting event finishers were included in final analysis. Pre- and post-race anthropometric and biochemical parameters were compared.ResultsThirty-six GTP (33 male) and 94 VGI (88 male) finishers were evaluated. GTP race median fluid intake was 800 ml/h, with 900 ml/h in the VGI race. 83.3% GTPfin and 77.6% VGIfin remained eunatremic (blood sodium 135–145 mmol/L). Only 1/36 GTP and 1/94 VGI participant finished in hyponatremia, both with a sodium level of 134 mmol/L. Fourteen percent of GTP, and 21.2% of VGI participants finished in hypernatremia, with no increase in race completion times. No participating athlete required medical attention, except for musculoskeletal complaints. Pro-BNP and Copeptin levels rose significantly. Changes in copeptin levels did not correlate with changes in plasma osmolality, nor total body water content in impedance analysis.ConclusionsRecommending that athletes' fluid intake in endurance events be a function of their thirst almost entirely prevented development of hyponatremia, without induction of clinically significant hypernatremia, or a negative repercussion on race completion times.https://www.frontiersin.org/articles/10.3389/fnut.2021.781229/fullexercisesodium disordershyponatremiahypernatremiacopeptin |
| spellingShingle | Diego López de Lara Jorge Gabriel Ruiz-Sánchez Martín Cuesta Germán Seara Alfonso Luis Calle-Pascual Miguel Ángel Rubio Herrera Isabelle Runkle Joseph George Verbalis Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions Frontiers in Nutrition exercise sodium disorders hyponatremia hypernatremia copeptin |
| title | Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions |
| title_full | Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions |
| title_fullStr | Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions |
| title_full_unstemmed | Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions |
| title_short | Exercise-Induced Hyponatremia: An Assessment of the International Hydration Recommendations Followed During the Gran Trail De Peñalara and Vitoria-Gasteiz Ironman Competitions |
| title_sort | exercise induced hyponatremia an assessment of the international hydration recommendations followed during the gran trail de penalara and vitoria gasteiz ironman competitions |
| topic | exercise sodium disorders hyponatremia hypernatremia copeptin |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2021.781229/full |
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