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(@deborah)
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With August football practice fast approaching, every coach's favorite cheer will be to "stay hydrated" and "keep urine clear" during the summer heat.

In 2017, a University of Texas football coach created a urine-based "Longhorn Football Hydration Chart," which labeled players with yellow urine as "selfish teammates" and those with brown urine as "bad guys." This "hydration shaming" practice has permeated high school sports, thereby encouraging a sporting culture which equates superior performance with superior hydration.

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Overzealous obedience to this hydration advice has uncovered a dark underbelly to superior hydration practices: overhydration. When high school football player Walker Wilbanks died in Mississippi in August 2014 from overhydration, the doctor said that the cause of death was an "unpredictable freak occurrence."

Two weeks prior, another high school football player from Georgia drank "two gallons of water and two gallons of Gatorade" after football practice to prevent muscle cramps and then died. Thus, over the last four years, two high school football players have died during August football practice from overhydrating – a medical condition known as exercise-associated hyponatremia.

Conversely, no football player has ever been known to die from dehydration, although seven died during this same four-year period from heatstroke, which may be related, but not always.

 

How do I know about that overhydration kills athletes? I watched runners almost die after drinking 100 cups of water during a marathon because they were scared of becoming "dehydrated." So, I got interested in thirst.

Turns out, the neuroendocrine thirst circuit dates back 700 million years and is found in most animals, including bugs and worms. Thirst activates the same conscious area of the brain that tells us we're hungry or have to pee. To say we need to stay "ahead of thirst" (or die) is like saying we need to pee every hour to stay ahead of imminent bladder explosion (or die). The molecular and neural circuits that govern fluid intake (and micturition) in real-time are absolutely exquisite.

It's remarkable to think that animals survive without water bottles and urine charts -- they drink when they are thirsty, and we should too.

Too much water, too little salt

Hyponatremia is caused by drinking too much water or sports drinks, which dilutes blood salt levels below the normal range. Any sudden drop in blood salt levels, from drinking more than the body can excrete, can cause all cells in the body to swell. Brain swelling from hyponatremia can cause headaches and vomiting, while muscle cell swelling can trigger whole-body muscle cramping.

What is most frightening, however, is that these symptoms mimic those of dehydration They are often treated by medical staff with more fluids.

So, which hydration imbalance -- dehydration and overhydration -- is the lesser of two evils?

Dehydration is undeniably harmful to human health and performance. Wrestlers have died from trying to "make weight," through vigorous dehydration practices. A recent meta-analysis of 33 studies verified that more than 2 percent dehydration impairs cognition. Dehydration can impair performance and increase core body temperature, as per the American College of Sports Medicine's latest position statement. All of these statements underscore the vital importance of staying hydrated.

But I fear that many coaches ignore the finer points that support those conclusions. For example, three wrestlers who died of dehydration rapidly lost about 15 percent of body weight by withholding fluids while exercising in a hot environment in a rubber suit. Similarly, to achieve 3 percent dehydration, which impairs cognition, individuals need to withhold fluids for 24 hours. And that's without exercise.

 

These dehydration protocols do not necessarily represent "free-living" situations. When hikers die from dehydration in the desert, most if not all had become lost or had run out of fluids. Thus, thirst – or the "deep-seated desire for water" – is rarely "broken" when healthy people die from dehydration. Morbidity and mortality occur when there is no fluid available, fluids are withheld, as in lab studies, or when athletes refuse to drink for other reasons, such as "making weight."

When do athletes and others need to drink?

So how much fluid should football players -- and all other humans for that matter -- drink? If you ask fluid balance experts who perform basic science research on the brain or kidney, or clinicians who specialize in fluid balance disorders, researchers who perform brain scans on dehydrated and overhydrated humans, or even worm investigators, they all agree that water balance is tightly regulated and that all land mammals need to drink when thirsty.

Drinking when you are thirsty is not "too late," because the thirst mechanism is hardwired into the nervous system to protect against scarcity. Thirst represents the highly individualized signal which protects the balance between water and salt regardless of size, activity or ambient temperature and is encoded in most invertebrate and all vertebrate DNA. Babies are born with this innate behavioral drive.

Then, what about the need for eight glasses of water per day? There is no evidence to support this. What about peeing until our urine is clear? Dark colored urine merely reflects water conservation by the kidney, rather than water lack by the body.

What's a football player to do?

Football players absolutely need water, but they should be warned not to overdo it.

In the modern era, where fluid is widely available, in order to stay adequately hydrated, the following must occur:

  1. A variety of fluids needs to be freely available to football players, and

  2. The players should be given the freedom to drink whenever they feel thirsty.

And when the players get hot, they need the opportunity to pour generous amounts of ice water over their heads instead of into their mouths to promote evaporative cooling, rather than dilute sodium levels. Better yet, they should be allowed to go inside and cool off.

We should recognize who the "true champions" may be with regards to most modern day hydration advice. According to the latest figures, bottled water sales have increased to $18.5 billion, up 8.8 percent from the previous year. This revenue does not include the vast array of purified, infused, oxygenized, sparkled, distilled, intravenous and reverse osmosis versions that compete for attention on the market.

While we all need water, drinking until our "urine is clear" is money (and water) flushed away. And with the threat of overdrinking high in motivated athletes, I ask coaches/trainers to reconsider before enforcing the urine color chart in athlete locker rooms: Is it worth the risk?

The Conversation

This article was originally published on The Conversation


   
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(@leejenkinsiectskin-com)
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Joined: 5 years ago
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This is also known as water intoxication and overhydration.  Its just as dangerous as being thirsty or dehydrated and can cause seizures coma and even death as the article above stated.  I often wonder when I go to the gym and see people with gallon jugs walking around if they're really gonna drink all that water while they're working out.  I take a modest size bottle of water and I usually finish it after I leave.  I think people have been programmed by health shows and water bottling companies to think we're all dying of thirst.  I think its wise to increase water intake when doing vigorous activities outside in the hot sun, but if it's too hot we'd be better off to wait until it gets cooler or take a lot of breaks.  These people who drink water all the time must spend a lot of time in the bathroom too.  How do they get anything done and how do they sleep at night when they're peeing all the time lol.  Like so many other things moderation is best .  Too much water flushes out sodium in the tissues and organs of the body and its literally like drowning on the inside.  I think 8 glasses a day spaced apart throughout the day is ok and a little less on days when we're not so active is ok too. 


   
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(@mikaylaalleniectskin-com)
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Joined: 5 years ago
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Drinking too much water can cause dizziness, fatigue, nausea, vomiting, and confusion. You wouldn't think something our body's need could be bad for us. Kidneys can only expel about half a liter in an hour. So basically you're drinking more water then you can pee out. It can also happen to babies that's why doctors say they can only have milk or formula. Gross, but pee should be a light yellow. If its too dark you're dehydrated and if its clear you're drinking too much. People should really drink based on their size because some people might need more or less than 8 glasses a day. 


   
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(@carliecannestroiectskin-com)
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Joined: 5 years ago
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I definitely heard that "if you wait until your thirsty then you've waited too late and it means your dehydrated". It is important to stay hydrated but I think at one point or another we have to use common sense, drinking 4 gallons of fluid in one sitting cannot be good for you. 


   
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(@rosariakenneyiectskin-com)
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i agree ...... too much of a good thing can be bad. When drinking too much water the body can go in hyponatremia putting too much stress on the kidneys making them over work trying to excrete the excess of water. Drinking 8 ounce glasses of water x day might be a reasonable amount for most people.


   
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(@doreengreeniectskin-com)
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Joined: 6 years ago
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When it comes to dehydration prevention is the best course of action. If you regularly exercise outdoors in humid or warm weather water intake should increase throughout the day during that time of year. Once you feel thirsty it is already too late, you are dehydrated. 

My son often takes a pinch of salt in his water first thing in the morning during summer months when he plays sports. One "trick" to Gatorade is that if it tastes sweet you are dehydrated and if it tastes salty you are well hydrated. It was designed to taste sweet to encourage consumption when dehydrated. 


   
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