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How people were convinced to drink despite not being thirsty

According to Beverage Industry Magazine, sales of sports drinks in the United States now exceed a staggering $3 billion annually. Internationally recognized human performance expert Tim Noakes credits much of the rise in the popularity of these drinks to the industry's modern marketing tactics and the strength of a unique positive product image. Unfortunately, these tactics have also led athletes and fitness enthusiasts to falsely believe they are unable to naturally monitor their hydration levels and drink accordingly.

In Waterlogged: The Serious Problem of Overhydration in Endurance Sports, Noakes debunks beliefs about hydration that have taken hold over the past 30 years. He shows how the past three decades have been not only a time of runaway success for the sports drink industry but also a time in which an epidemic of exercise-associated hyponatremia (EAH), a potentially fatal condition caused by overdrinking during extended exercise, has struck endurance athletes worldwide. “If drinking during exercise was so important,” Noakes says, “then why should a product that contains no unique molecules ever be taken seriously, especially if its core ingredients of glucose, salt, water, and a dash of lemon are present in even the most rudimentary kitchen?”

As Noakes' research shows, sports drink industry marketing methods have helped sustain the idea that dehydration is a condition with a specific set of symptoms (like confusion, dizziness, nausea, cramping, and fainting) that can be diagnosed and prevented, such as by ingesting more sports drinks during exercise. “Of course, if a patient's symptoms are not due to a reduction in the total-body water, then those symptoms caused by some other condition will not disappear when the patient is either told to drink more or is treated with intravenous fluids after exercise,” Noakes says. As a result, he believes the treatments are more likely to cause or exacerbate the underlying condition.

Noakes, also a medical doctor and an exercise physiologist, stresses that the only symptom of dehydration is thirst; it is not a medical condition or disease that produces a variety of unique symptoms. So, if an otherwise healthy athlete seeking medical care is not thirsty, it is unlikely that dehydration is the cause of any illness or symptoms that may be present at the same time. “Not surprisingly,” Noakes points out, “thirst is an uncommon complaint in athletes treated during and after endurance events in which fluid is freely available.” As well as being an uncommon complaint, thirst is not even listed as a symptom of dehydration by those who have promoted it as a disease.

Noakes believes that the widespread disinformation about the need for sports drinks to treat dehydration helps explain why doctors often treat patients incorrectly, thinking those patients are dehydrated when, in reality, they are overhydrated. “It is disturbing that incorrect advice to the public and the public's own susceptibility to promotional efforts resulted in a novel medical condition that affected thousands of soldiers, hikers, runners, cyclists, and triathletes, causing some to die,” Noakes comments. “Sadly, this phenomenon and the deaths that apparently resulted from it were preventable.”

Noakes believes that as bad as water restrictions and required ingestion of salt tablets were during the 1960s, so too is the current, and nearly universal, notion of drinking despite lack of thirst. He sees today's athletes, parents, coaches, and even many professionals in medicine, fitness, and sport science pushing the intake of fluid far beyond the bounds of what solid research suggests. “Indeed,” Noakes contends, “tens of millions of athletes and fitness enthusiasts are waterlogged in that the hydration practices to which they religiously adhere adversely affect their health and performance.”

Waterlogged: The Serious Problem of Overhydration in Endurance Sports outlines practices that endurance athletes should follow, variables they should consider, and guidelines they should use in maintaining proper fluid balance in sport training and performance. Learn more about Waterlogged.