Document Detail

Drinking guidelines for exercise: what evidence is there that athletes should drink "as much as tolerable", "to replace the weight lost during exercise" or "ad libitum"?
MedLine Citation:
PMID:  17454546     Owner:  NLM     Status:  MEDLINE    
The most recent (1996) drinking guidelines of the American College of Sports Medicine (ACSM) propose that athletes should drink "as much as tolerable" during exercise. Since some individuals can tolerate rates of free water ingestion that exceed their rates of free water loss during exercise, this advice has caused some to overdrink leading to water retention, weight gain and, in a few, death from exercise-associated hyponatraemic encephalopathy. The new drinking guidelines of the International Olympic Committee (IOC), recently re-published in this Journal, continue to argue that athletes must drink enough to replace all their weight lost during exercise and to ingest sodium chloride since sodium is "the electrolyte most critical to performance and health". In this rebuttal to that Consensus Document, I argue that these new guidelines, like their predecessors, lack an adequate, scientifically proven evidence base. Nor have they been properly evaluated in appropriately controlled, randomized, prospective clinical trials. In particular, these new guidelines provide erroneous recommendations on five topics. If novel universal guidelines for fluid ingestion during exercise are to be promulgated by important international bodies including the IOC, they should first be properly evaluated in appropriately controlled, randomized, prospective clinical trials conducted under environmental and other conditions that match those found in "out-of-doors" exercise. This, and the potential influence of commercial interests on scientific independence and objectivity, are the two most important lessons to be learned from the premature adoption of those 1996 ACSM drinking guidelines that are not evidence-based. These concerns need to be addressed before the novel IOC guidelines are accepted uncritically. Otherwise the predictable consequences of the premature adoption of the 1996 ACSM guidelines will be repeated.
T D Noakes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of sports sciences     Volume:  25     ISSN:  0264-0414     ISO Abbreviation:  J Sports Sci     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-06-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8405364     Medline TA:  J Sports Sci     Country:  England    
Other Details:
Languages:  eng     Pagination:  781-96     Citation Subset:  IM    
UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
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MeSH Terms
Evidence-Based Medicine
Guidelines as Topic
South Africa

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