Like many marathon runners, Kate Mori always drank plenty of fluids
before, during and after a race, rather than waiting until she got
thirsty.
"I'd always been taught you had to 'stay ahead' of thirst and that
being thirsty was a sign you were already dehydrated," says the
42-year-old sports scientist. In 2007, Mori took part in the London
Marathon - her fourth, and the hottest on recos peaking at 23.5C.
Conscious of the repeated advice to maintain fluid intake coming over
the PA system, she took frequent drinks at the water stations along the
route.
By the 18th mile, Mori felt "quite poorly" but was
determined to finish; she was raising funds for a children's cancer
charity and wanted to ensure they got their sponsorship money. Near the
end, she needed help from other runners to stay upright; hours later she
was in casualty at the Royal London Hospital in Whitechapel, suffering
from severe diarrhoea, vomiting and increasing confusion, with her legs
endlessly mimicking a running motion. "I thought I was still in the
marathon," she says.
Mori was not dehydrated from drinking too
little fluid, as might be at first assumed. She had drunk too much. As a
result she had developed a dangerous but little-recognised condition
called exercise-associated hyponatraemia (EAH). Sometimes called water
intoxication, EAH is marked by a low blood sodium concentration and can
cause the brain to swell, causing confusion, loss of consciousness and
seizures.
Mori made a full recovery after intravenous treatment
with sodium chloride to redress the low concentration of sodium in her
blood. Another contestant in that year's marathon was not so fortunate.
David Rogers, a 22-year-old fitness instructor, died of EAH after
finishing the race in three hours 30 minutes.
Mori isn't sure how
much she drank during the race. "But the consultant reckoned it was
probably about three litres of water," she says. "Ironically, at the
finish I was taken into a first aid tent and offered more water.
"I
feel ashamed that with my job [she teaches an MA in sports development
at Gloucestershire University] I did not have the awareness about this
condition," she adds. "It is far more dangerous than dehydration."
With
the 2012 London Marathon taking place next month, most would-be runners
will be similarly advised on the need to avoid dehydration, especially
if temperatures rise. Dehydration occurs when the body's normal water
content is reduced and its balance of salts and sugar upset. But
according to many medical experts, thousands of runners could be risking
their health if not their lives by drinking too much rather than too
little.
Timothy Noakes, professor of exercise and sports science
at the University of Cape Town, South Africa, who has spent the last 30
years researching the topic, says that the dangers of dehydration during
endurance exercise have been exaggerated, with the result that cases of
EAH are on the rise. He says runners need to be warned that
overconsumption of fluids (whether water or sports drinks) before,
during, or after exercise can have a potentially fatal outcome.
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