The Relationship of Hydration Strategies and NSAIDs Use on Self-Reported Symptoms of Dehydration and Hyponatremia in Runners Participating in the ING Georgia Marathon

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Participants of the 2007 ING Georgia Marathon completed an on-line survey that inquired about common hydration strategies and frequency of NSAIDs use. PURPOSE: To investigate the degree to which runners follow established hydration protocols, and whether NSAIDs use increased the severity and/or frequency of symptoms associated with dehydration and hyponatremia. METHODS: The survey procedure was approved by the IRB of Georgia State University. The electronic sign-up for the marathon included an option to complete this survey, which contained questions on demographics (age, gender, height, weight, ethnicity, education, income), where runners live and train (using zip codes), NSAIDs use (type, frequency of use, amount of use), hydration strategy (type and amounts of beverages consumed, frequency and timing of consumption), and frequency of signs and symptoms associated with dehydration and/or hyponatremia (nausea, dizziness, headache, edema, breathlessness, vomiting, memory impairment, balance loss, exercise associated weight change). RESULTS: 2,073 volunteer participants (15% of race registrants) completed the survey [(1136 females (F); 937 males(M)]. Mean age was 39 yr ± 10.5 (F 37.5 yr ± 10.0; M 40.9 yr ± 10.8). Approximately 40% (n=837) of the subjects reported taking NSAIDs before or after training (F 42.7%; M37.6%), and approximately 26% (n=533) planned to take NSAIDs before the ING marathon (F 28.3%; M 22.6%). More subjects reported having a competition-related drink strategy [(total 66% n=1368); (F 62.9% n=714); (M 69.8% n=654)] than for long training runs [(total 57.6% n=1195); (F 55.8% n=634); (M 59.9% n=561)]. There were fewer symptoms of dehydration/hyponatremia in those who consumed beverages during runs than those who did not (p < .05). NSAIDs consuming F, but not M, reported less breathlessness than F not taking NSAIDs (p=.014). NSAIDs consuming M and F reported fewer headaches than those not taking NSAIDs (p<.04). There was also greater frequency of swelling, nausea, and memory impairment among NSAIDs users (p<.03). CONCLUSIONS: These findings suggest that nearly 35% of marathon participants do not have an appropriate hydration strategy, which increases heat stress disorder risk. There was some indication that NSAIDs use exacerbates the symptoms of dehydration and/or hyponatremia.