FLUID REPLACEMENT GUIDELINES FOR ATHLETES

YOU FEEL DEHYDRATED BEFORE YOU FEEL THIRSTY

The American College of Sports Medicine (ACSM) has expressed concern that editorial remarks published in the July 19 issue of British Medical Journal criticizing existing guidelines on fluid replacement may lead to potentially dangerous misinterpretation by athletes, coaches, and healthcare providers. Further, ACSM experts emphatically deny that water and sports drinks, when consumed as recommended, are dangerous to athletes. Recommended fluid intake before, during, and after exercise is an important part of regulating body temperature and replacing body fluids lost through sweating.

ACSM experts contend that thirst alone is not the best indicator of the body's fluid status. Dehydration resulting from the failure to replace fluids during exercise can lead to impaired heat dissipation, which can elevate body core temperature to dangerously high levels. Dehydration is a threat to all athletes, but especially to those who are not used to strenuous activity in hot environments. As noted in the ACSM Position Stand, proper fluid ingestion prior to and during competition prevents or delays the detrimental effects of dehydration.

Dehydration can limit the body's ability to regulate body temperature by sweating and/or skin blood flow and may contribute to heat exhaustion, heat injury, and exertional heat stroke. To minimize the potential for thermal injury, ACSM experts have recommended that athletes attempt to replace fluid losses by consuming fluids at a rate equal to the sweat rate. Recommendations are based on scientific data and observation of athletes suffering from heat injury.