Abstract
Purpose: Little information is available on the association of hydration beliefs and behaviors in endurance athletes and exercise-associated hyponatremia (EAH). The aim of the present study was to determine hydration beliefs and behaviors in endurance athletes.Method: A 100 and 38 recreational athletes [107 mountain bikers (MTBers) and 31 runners] competing in seven different endurance and ultra-endurance races completed pre- and post-race questionnaires, and a subgroup of 113 (82%) participants (82 MTBers and 31 runners) also provided their blood samples.Result: More than half of the participants had some pre-race (59%), mid-race (58%), and post-race (55%) drinking plan. However, the participants simultaneously reported that temperature (66%), thirst (52%), and plan (37%) affected their drinking behavior during the race. More experienced (years of active sport: p = 0.002; number of completed races: p < 0.026) and trained (p = 0.024) athletes with better race performance (p = 0.026) showed a more profound knowledge of EAH, nevertheless, this did not influence their planned hydration, reported fluid intake, or post-race plasma sodium. Thirteen (12%) hyponatremic participants did not differ in their hydration beliefs, race behaviors, or reported fluid intake from those without post-race EAH. Compared to MTBers, runners more often reported knowledge of the volumes of drinks offered at fluid stations (p < 0.001) and information on how much to drink pre-race (p < 0.001), yet this was not associated with having a drinking plan (p > 0.05). MTBers with hydration information planned more than other MTBers (p = 0.004). In comparison with runners, more MTBers reported riding with their own fluids (p < 0.001) and planning to drink at fluid stations (p = 0.003). On the whole, hydration information was positively associated with hydration planning (n = 138) (p = 0.003); nevertheless, the actual reported fluid intake did not differ between the group with and without hydration information, or with and without a pre-race drinking plan (p > 0.05).Conclusion: In summary, hydration beliefs and behaviors in the endurance athletes do not appear to affect the development of asymptomatic EAH.
Highlights
The main reason for fluid intake during endurance events is to reduce the fluid deficit caused by the loss of sweat (Garth and Burke, 2013)
More experienced and trained participants with better place in the race showed a higher knowledge of exercise-associated hyponatremia (EAH), which, did not influence their hydration strategy, or their post-race plasma [Na+]
Hydration information was positively associated with hydration planning; the actual reported fluid intake did not differ between the groups with and without hydration information or with and without a prerace drinking plan
Summary
The main reason for fluid intake during endurance events is to reduce the fluid deficit caused by the loss of sweat (Garth and Burke, 2013). A large number of halfmarathon and full-marathon runners (O’Neal et al, 2011) believe that dehydration results in major performance decrements and that heat-related symptoms are caused by inadequate fluid intake. EAH occurring during or up to 24 h after physical activity is known to be a possible complication of endurance events and may have a fatal outcome (Noakes, 2012; Hew-Butler et al, 2015). There are alternative views that ad libitum drinking is sufficient to replace sweat losses or that thirst should dictate the need for drinking (Noakes, 2011, 2012; Hew-Butler et al, 2015)
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