Tim Noakes on the Serious Problem of Overhydration in Endurance Sports

Shutterstock_78076102Man and water. Photo: Shutterstock

South African exercise scientist Dr. Tim Noakes wants to change the way endurance athletes think about hydration. He believes that, over the course of the last 30 years, people have been scared into drinking too much fluid while exercising. As a result, he says performance has suffered and people have died. He’s counted a dozen deaths in endurance events caused by exercise-associated hyponatremia, a condition that results when athletes drink too much fluid.

Noakes earned Doctor of Medicine and Doctor of Science degrees from the University of Cape Town in South Africa and has raced in more than 70 marathon and ultramarathon events. He has written more than 50 studies on the subject, but his pièce de résistance is Waterlogged: The Serious Problem of Overhydration in Endurance Sports, a 429-page book released last month. He said all of the overhydration started with the dawn of sports drinks and guidelines that called for people to drink ahead of thirst. Since Noakes began his fight, the American College of Sports Medicine has changed some of its guidelines, but he wants more. We called Noakes to talk about his ideas for the new rules of hydration during endurance exercise, which he points out are actually old rules.

Why write this book?
I had a responsibility. I was one of the few people around in the 1960s running and I’m still around now. I’ve seen the change in advice that people have been given. I was around when people were advised not to take fluids during exercise. Then we went to the phase where we were told to drink a lot of water during exercise. Now we are getting back to more appropriate guidelines. I was also the first person to discover a lady who developed hyponatremia; she drank too much and almost died as a consequence. We were the first to show that, and it came at a time that was very inappropriate because the industry was just starting to encourage runners to drink more than they need. So I had a responsibility to say, Listen, if you advise runners to overdrink you are going to have problems. That did happen. This book explains exactly why it happened and how it could have been avoided.

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