Tuesday, September 9, 2014

Drinking too much water can be fatal for athletes

Recent deaths of high school football players focus attention on hyponatremia

Drinking too much during exercise can overwhelm the body’s ability to remove water. Overhydration by athletes is called exercise-associated hyponatremia.

The recent deaths of two high school football players illustrate the dangers of drinking too much water and sports drinks, according to Loyola University Medical Center sports medicine physician Dr. James Winger.

Overhydration by athletes is called exercise-associated hyponatremia. It occurs when athletes drink even when they are not thirsty. Drinking too much during exercise can overwhelm the body’s ability to remove water. The sodium content of blood is diluted to abnormally low levels. Cells absorb excess water, which can cause dangerous swelling in the brain.

Hyponatremia can cause muscle cramps, nausea, vomiting, seizures, unconsciousness and, in rare cases, death.

Georgia football player Zyrees Oliver reportedly drank two gallons of water and two gallons of a sports drink. He collapsed at home after football practice and died later at a hospital. In Mississippi, Walker Wilbank was taken to the hospital during the second half of a game after vomiting and complaining of a leg cramp. He had a seizure in the emergency room and later died. A doctor confirmed he had exercise-associated hyponatremia.

And in recent years there have been more than a dozen documented and suspected runners’ deaths from hyponatremia.

Winger said it’s common for coaches to encourage athletes to drink profusely before they get thirsty. But he noted that expert guidelines recommend athletes drink only when thirsty. Winger said athletes should not drink a predetermined amount or try to get ahead of their thirst.

Drinking only when thirsty can cause mild dehydration. “However, the risks associated with dehydration are small,” Winger said. “No one has died on sports fields from dehydration, and the adverse effects of mild dehydration are questionable. But athletes, on rare occasions, have died from overhydration."

Winger is co-author of a 2011 study that found that nearly half of Chicago-area recreational runners surveyed may be drinking too much fluid during races. Winger and colleagues found that, contrary to expert guidelines, 36.5 percent of runners drink according to a preset schedule or to maintain a certain body weight and 8.9 percent drink as much as possible.

“Many athletes hold unscientific views regarding the benefits of different hydration practices,” Winger and colleagues concluded. Their study was published in the British Journal of Sports Medicine.

Winger is an associate professor in the Department of Family Medicine of Loyola University Chicago Stritch School of Medicine in Maywood, Ill.

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.