Health Sentinel: For hydration, water typically beats sports drinks

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I loved watching the Olympics, especially gymnastics, diving and track and field.

I felt the joy on the faces of the USA “Fab Five” gymnasts when they realized they'd won gold in team competition. Seeing South Africa's Oscar Pistorius, nicknamed the “Blade Runner” because of his prosthetic legs, compete with the best human legs in the running world was nothing short of astonishing.

The Olympics — all sports and forms of exercise, for that matter — are about putting the body in motion. It's a good thing, as Martha Stewart would say, and to keep the body going we need fuel — carbs, protein and other nutrients — plus hydration. The body is about 75 percent water, after all.

At this year's Olympics, hydration was a point of controversy, particularly in light of a package of stories on the issue published in the peer-reviewed British Medical Journal (BMJ) just prior to the start of the games.

“The Truth about Sports Drinks,” by BMJ investigations editor Deborah Cohen, sheds light on how we've been sold a false bill of goods that sports drinks are good for active, sweating bodies expending energy. Ironically, Powerade, made by Coca-Cola, and Gatorade, made by PepsiCo, were approved Olympic sponsors; Lucozade, made by SmithGlaxoKline (a major pharmaceutical company) is a sponsor of some of the competitors.

Cohen and other contributors to the July 18 BMJ issue say the understanding of what hydration is and how to achieve it has been tweaked and tainted by makers of those colorful fluids that claim to hydrate the body, prevent heat stroke, prevent muscle cramps, improve performance and maybe grow hair on a bald head. Forget the last one — I just threw that in.

What is most egregious is that the science touted by the drink companies is weak and flawed: Too few subjects in most of the studies — one study had just seven subjects — and too many variables among subjects, which compromised validity of outcomes.

Despite the flaws, some major health organizations, particularly in Europe, have turned their good science eye the other way and made health recommendations based on the flawed sports drink research.

Follow the money, and you find the close connection between the funders of the research and the drink manufacturers. But isn't that usually how it goes? U.S. drug companies fund the research, which is evaluated by the FDA (U.S. Food and Drug Administration) before the drug is approved and marketed to the public.

But these drinks are not drugs, per se, and, even in this country, direct-to-consumer marketing has been shown to influence prescribing practices by doctors when patients ask for specific drugs.

Cohen points out that, when science is heavily influenced by biased funders, a normal body need or condition such as hydration takes on new meaning, a redefinition that aligns with the product rather than the product targeting a more finite need or condition.

The thinking that you drink when you are thirsty and that water is best for rehydration has morphed into dehydration as almost a disease. To “cure” that disease, we need carbohydrates (sugar), sodium, some minerals and water.

One 8-ounce glass of Gatorade (the regular version, not the G Series), for example, has 14 grams of sugar, 110 milligrams of sodium, 30 milligrams of potassium and 93 milligrams of chloride; the latter are electrolytes needed to generate energy and for cellular activities, such as moving water and fluids within the body.

So running a marathon or even mowing your yard for two hours on a hot day will use up these essential nutrients. But is replenishing them with sports drinks the answer?

Harvard Medical School associate professor Dr. Arthur Siegel, who is a medical advisor for the Boston Marathon, says there has never been a known case of a marathoner dying from dehydration. But at least 16 marathoners are known to have died from over-hydration, according to information found on the Harvard Health Blog.

The runners take in so much water prior to or during the race that their sodium levels are depleted, a condition called hyponatremia. Most sports drinks contain sodium so logic would say they are the answer. Possibly, but caution is the word. One Harvard study of marathoners who had lab testing for hyponatremia after running found no difference in incidence between sports drink users and water drinkers.

Particularly for young athletes, sports drinks have become the drink of choice to hydrate, so I asked Fort Wayne's former “The Biggest Loser” TV show competitor Mike Danley, also a longtime high school assistant football coach, for his opinion on the issue. Danley was one of 15 participants on the reality show last fall.

He's kept off the more than 100 pounds he lost thanks to diet changes and grueling hours of rugged workouts on the show's California “farm.” Between tapings of the show, he spent three to five hours a day working out at Absolute Results in Fort Wayne.

In all his time on the “Biggest Loser,” with personal trainers and sports medicine physicians at his side, he was never given a sports drink to rehydrate and replenish electrolytes. The only time it was given was if a participant, after undergoing testing prior to a weigh-in, was found dehydrated.

“We were always given water,” Danley says. Though he is not coaching this fall so he can keep the exercise regimen he needs to maintain the health he's regained, he says schools do offer sports drinks to athletes during heavy practice times and at games, but they are always watered down.

Even then, if an athlete chooses the sports drink, usage must be alternated with straight water. Summing it up succinctly, he says, “Water's still the best.”