Wednesday, July 1, 2009

Question on Sports Drinks

I just received a great question from a coach about what he should tell the athletes he coaches about sodium and protein in sports drinks during long events such as Ironman. Here is my reply...

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I’ve been doing a lot of reading in the literature and talking with informed people regarding, especially, sodium. I’m coming to the conclusion that sodium is not necessary during exercise for all of the reasons we have previously been told were so critical - cramping, coping with heat, and maintaining pace/power. I can find no good evidence to support any of these. Just a lot of opinions and sports drink marketing stuff (which most athletes have come to accept as factual).

That said, sodium is beneficial in the transport of water across the intestinal mucosa in the upper intestine where it is absorbed. In other words, with a bit of sodium in the drink you get more water into the body. That may be beneficial to performance if there is a real risk of excessive dehydration (which is far too often blamed for poor performance). As I’ve mentioned before, the most dehydrated athlete in the race is typically the winner. But this is a whole other discussion.

Is protein necessary or even beneficial in a sports drink? The research is murky on this still. However, there is something called “central fatigue” which has to do with the central nervous system experiencing the need for sleep during extended exercise. This seems to be related to circulatory branched chain amino acid status. A couple of studies have suggested that taking in protein during or before exercise may prevent this. But the condition seems to be quite rare. Interestingly I spoke with an athlete a few days ago who did an Ironman and felt like he just wanted to lay down beside the road while in the bike leg and take a nap. This may have well been central fatigue.

What do I do? I eat well before starting a workout. Then I drink water only when thirsty on very long rides and carry carb products such as gels and bars in my pockets. They have a small amount of sodium and negligible protein. Water-only works fine for the first two hours on long, easy to moderately hard rides for me. Then I start taking in carbs along with the water. For example, last week I rode over 500 miles in the Colorado mountains with thousands of feet of moderately hard climbing every day. The average duration was nearly 5.5 hours a day for 6 days. I did just what is described above and never experienced the least bit of problems.

But that was an n=1. Individual athletes may well have unique needs I don’t have for any number of reasons. Some experimentation (with an open mind) is necessary to discover what works. The problem is that most athletes have been so inundated with marketing hype (much of it from “science”) that they can no longer think critically.

I tell the athletes I coach that if they want to use sodium during exercise that’s alright. I know of no downsides (although there may well be some we don’t know about yet such as balancing potassium and sodium, and inter- vs intracellular fluid levels). The same goes for protein. It’s up to them if it has worked ok in the past. If they have had digestive tract problems such as nausea or the gut “shutting down” then I suggest omitting the protein.

Generally, I have come to believe that we need far less “stuff” in our guts during exercise than we have come to believe over the last 30 years. The only two things that seem to stand the test of time are water and carbohydrate. And it’s quite possible to be excessive with both of these.

I hope this helps a bit. I wish I could tell you without question that what I’m suggesting here is irrefutable. It’s where my head is right now on this subject. Time marches on.

38 Comments:

At July 1, 2009 7:40 AM , Anonymous C Camillo said...

Joe, thanks for the info. But what about when training in hotter/humid conditions. doesn't all the dried salt on my team kit tell me to use those hi sodium blocks, or similar?

I have been combining 1 water with 1 electrolyte bottle and refilling in same ratio over longer (50+) rides.
Thanks, Chip.

 
At July 1, 2009 10:25 AM , Blogger Jim Vance said...

Joe,

Great post. What is the amount/concentration of salt in a drink which would be appropriate for helping transport water across the membranes of the intestines?

Jim Vance

 
At July 1, 2009 11:28 AM , Blogger Joe Friel said...

Hi Jim--I can find no info on that in the research or in physiology texts. It is often cited as a given with nothing to back it up. I'll continue searching.

 
At July 1, 2009 11:44 AM , Blogger Joe Friel said...

C Camillo--Thanks for your note. Dr. Noakes (Univ of cape Town in S Africa) who many consider to be the leading authority on the topic of race hydration says that salty splotches on your clothing after a race means you have too much sodium in your diet.

 
At July 1, 2009 12:03 PM , Blogger MK said...

Is exterior sodium splothing an indication of less fitness or over excertion (ie: maybe less efficient at cooling)?

Thanks!

 
At July 1, 2009 12:19 PM , Blogger Joe Friel said...

MK--As mentioned to C Camillo above, Tim Noakes, PhD believes salty splotches on clothing during/after a race means too much sodium in diet.

 
At July 1, 2009 1:22 PM , Blogger Speedy said...

Personally, I do better at the end of races in high temperatures if I consume/drink products that have a higher sodium content. I've only ever cramped once at the end of a cycling race, and I believe that was because I didn't have extra sodium nor did I drink enough.

 
At July 1, 2009 2:06 PM , Anonymous Ian McGinley said...

What about other 'salts' and their contribution? Magnesium, Calcium, Potassium which are common in a popular sports drink made here in Australia called Staminade.

 
At July 1, 2009 3:56 PM , Anonymous Anonymous said...

Joe:
Where does your "Joe's Ultra Fit Cycling Drink" fit into your most
recent thoughts on sports drinks?

 
At July 1, 2009 4:34 PM , Blogger Joe Friel said...

Anon--I no longer promote it.

 
At July 2, 2009 8:39 AM , Blogger Ryan said...

Joe,
Can you direct us to any articles discussing why the most dehydrated athlete normally wins.

I'm going nuts thinking of reasons this may be the case.

Thank you,

Ryan

 
At July 2, 2009 8:44 AM , Blogger Joe Friel said...

Hi Ryan--Go here and scroll down the page to read about dehydration http://tinyurl.com/4fwdps

 
At July 2, 2009 10:03 AM , Anonymous Anonymous said...

What about Hyponatremia and the advice you give on this subject in your book the Paleo Diet for athletes regards sodium consumtion?

Mike

 
At July 2, 2009 12:37 PM , Blogger Joe Friel said...

Anon--The problem with writing a book is people will never allow you to change your mind again. Time marches on.

 
At July 2, 2009 3:13 PM , Blogger kjbetz said...

Joe, thanks for writing such a great blog and your continued efforts in all aspects of training. I'm a big fan of your work.

This is a subject I've actually been wondering about quite recently. But it's more from a different angle.

I'm currently an Army soldier deployed in Iraq. Right now it is HOT! I've definitely felt the effects of the heat and last weekend got hit pretty hard.

To be honest, I'm currently not in my best shape and not eating as well as I should be. I know this has an affect on this as well.

But when dealing with extreme temperatures (~120 degrees F), moderate to extensive work, sweating, and salt splotching, and LOTS of water intake... what is the risk of hyponatremia? Is it something to really be worried about? Do sports drinks (Gatorade in particular - readily available here) provide needed salt / electrolyte additions?

Thanks for any input, it's appreciated.

 
At July 2, 2009 4:07 PM , Blogger Joe Friel said...

kjbetz--Thanks for your comment, and for serving over there. I expect the temps are about like Phoenix or maybe even a little warmer there. I know about that sort of heat first hand. If you are drinking only when thirsty you are at no risk of hyponatremia. Thirst is triggered in part by a rising sodium concentration due to a loss of body fluid with sweat. As the concentration rises it causes you to become thirsty so you drink. When you drink it dilutes the sodium back to normal concentration. It takes very little sodium to maintain your normal level. You get all you need from the food you eat. Probably more than you need. In fact, there is very recent research showing that the body apparently has a storage site for sodium in the body which was unknown just a few months ago. There is no good info about where it is but assumed to be, for right now anyway, in cartilage or bone. Bottom line is, you don't need to worry about sodium regardless of what all the marketing by sports drink companies and others have been telling us for nearly 30 years now. Athletes did quite well without it for decades but now for some reason we MUST have it. If you tell a myth long enough people will eventually come to believe it.

 
At July 2, 2009 4:14 PM , Blogger kjbetz said...

Thanks for the quick reply and the input. It helps. I recently was in Arizona and have family there as well, and yes Iraq is very similar (in my opinion) in climate with parts of AZ. Probably about 10 degrees F warmer.

Your comments as well as the others posted above make sense. I probably have more to worry about being dehydrated than hyponatremia. I will continue to concentrate on monitoring fluid intake by thirst and urine color as I've been doing.

Again, thanks for your comments on the subject.

 
At July 2, 2009 7:58 PM , Anonymous Sanna Carapellotti, MS CHT said...

Thanks, Joe. I am so happy someone is speaking out about the 'marketing' of sports drinks. There is a lot of misinformation out there.

I will refer my clients to review your info. My work is performance coaching thru hypnosis, EFT and guided experiences for sports and the arts.

Thank you!

 
At July 2, 2009 8:39 PM , Blogger bangertt said...

joe, i experienced something unusual on that ride in colorado last week, an unusual sensitivity to the altitude, i followed prescribed acclimation and noticed a definite reaction to the point i had to visit the medical tent in crested butte, i was told to increase my salt intake and use a sports drink as well check my calorie intake. that seemed to balance out the rest of the ride and i took it relatively easy on the last 2 days making sure to stop often and replenish. any experience with anything like this? thanks.

 
At July 3, 2009 4:20 AM , Blogger Joe Friel said...

bangertt--Thanks for your comment. It's really hard to say. Not sure what you mean by 'reaction' and 'sensitivity.' Common conditions in acclimation are nausea, fatigue and sleepiness. You also tend to use more carbohydrate for fuel at altitude. I know of no connection between sodium and altitude.

 
At July 3, 2009 3:23 PM , Anonymous Anonymous said...

Hi Joe, great to see you taking a stance on the ridiculous hype surrounding the need for sodium in short (eg less that 6 hr) events. I think there has been a lot of marketing/manipulation around this issue. As a physician and exercise scientist, I hate seeing fellow athletes get sucked into the pseudo-science that so many pass off as fact.

I do recall some research around sodium intake increasing intravascular volume and decreasing urine output in long events. This theoretically could be useful as a mechanism to defend cardiac output. Pretty vague, but worth thinking about.

Cheers,
William

 
At July 4, 2009 2:41 AM , Anonymous Anonymous said...

I am interested to read more about the protein segment? I went for a 3 hour ride a last Sunday, bokned afer one half hours and limped home taking the rest ofteh day to recover. Tuesday up at 4:30 ,wind trained 60 min and ran 30min then off to work, ate 2 hours later. Wednesday up at 4:30am, 80 min hill run and off to a sports massage and ate 2 hours later, this nailed me and I needed to take the next day off work and did not train again till the following Sunday due to fatigue? Afte rthe SUnday session I also felt fatigued? How do you know how much to drink and eat of protein and carbs to be in "bakance"?

 
At July 4, 2009 4:25 AM , Blogger Joe Friel said...

Anon--This is primarily a carb issue. protein is a very minor contributor to energy, and then only during long workouts when carb intake is inadequate. How much carb you need depends on several variables such as what and how much you've eaten prior to exercise, your body's preference for using carb vs fat for fuel (some are fat burners and some are suar burners), how long the workout is, how intense the workout is, how long and intense previous workouts were and how good of a job you did of replacing expended carb sources after them, and more. Bottom line is, there is no number I can give you. Replacing fuel sources is largely a matter of experience. In the last couple of years i have coached Ironman athletes who varied considerably in their race day needs. One, for example, took in nearly 3 calories per pound per hour. On the other end of the spectrum, another used 1.6 calories/pound/hour. Their races had similar times. Your breakdown may well have been due to inadequate refueling. But it may also be related to your fitness level relative to the training you did in that short period of time. And there are other possible variables, too. Training is at least as much art as science.

 
At July 4, 2009 6:02 AM , Blogger PGribbon said...

when did you change your thinking on gels? in an interview last yr you said that you should only drink sport drinks, that gels where like taking a sport drinks ingredents and putting them in your stomach and mixing them up. So now you recommend gels?

 
At July 4, 2009 6:25 AM , Blogger Joe Friel said...

pgribbon--Thanks for your note. Yes, I have indeed changed my mind on that topic. In fact, I've changed my mind on many things in my life, and most recently on fueling and hydration strategies during exercise. About 10 years ago I went to a talk by a running coach who was quite famous in the '60s and '70s. He had apparently not changed his mind on anything related to training in 30 years. Sad.

 
At July 6, 2009 8:10 AM , Blogger Kevin said...

Any recommendations on what to use for fuel and hydration in a typically intense hot 2 hour mountain bike race? I got caught up in the sodium hype this weekend, using supplements, and still had the legs in lactate shut down mode towards the end. Are you aware of any studies regarding watered down Gatorade versus other more expensive sports drinks? Thanks.

 
At July 6, 2009 9:17 AM , Blogger Joe Friel said...

Kevin--You need water and carb. Experiment to find what works best for you.

 
At July 6, 2009 10:33 AM , Blogger debcyr said...

Hi Joe,

What about protein enhanced drinks as a way to reduce muscle damage (+DOMS) during prolonged exercice ?

Thks

// CD

 
At July 6, 2009 11:04 AM , Blogger Joe Friel said...

debcyr--Thanks for your comment. Good question. There is some research indicating that a protein-carb drink mix during and/or after exhaustive exercise reduces muscle damage. (For those who care: Saunders 2005, Miller 2002, Blomstrand 1992, Millard-Stafford 2005, Berardi 2006.) Realize that the more stuff you put in your sports drink the more slowly it is likely to be emptied from the gut. I talk with many ironman athletes who deal with this issue more than those in most other sports. The trend for them is to eliminate protein from their sports drinks due to gastric problems ("stomach shut down"). I'd suggest the best time for protein intake is immediately post-exercise, not during.

 
At July 7, 2009 8:07 AM , Anonymous Anonymous said...

Hi Joe, I can understand that we need energy from carbs, but the question I had is, how do you prevent or minimize cramping. I notmally do not cramp, but when I push the effort harder, after about 3 plus hours, I may experience some. I feel I'm fit pretty well for the bike, and do take in nutrition, with sodium, but still experice this occasionally. Salt has seemed to help a little, but perhaps I need to have higher level efforts more often to get used to it. What have you experienced with athletes who cramp, and have overcome it?

Randall

 
At July 7, 2009 3:48 PM , Blogger Joe Friel said...

Randall--The old myth that some how sodium is associated with cramping refuses to go away. Millions of dollars spent on marketing a sports drink will do that, I guess. Please go here - http://tinyurl.com/4fwdps - and scroll down the page to find articles on cramping that summarizes much of what is going on in this field.

 
At July 7, 2009 7:59 PM , Anonymous Ed said...

I've always been amused by how my desires for food change over the course of a ride. I'm thinking slow, moderately long stuff here. At the beginning, sweet things are appealing, but by the end sour salty things appeal. Bliss once was a soft, salty pretzel with mustard after 80 hot, humid miles with more left to go. I would have gagged on a sweet sports drink. I'm not saying I needed salt, but it is interesting how taste / desire changes and that affects the ability to get stuff down the hatch to start the refueling.

 
At July 13, 2009 11:06 AM , Anonymous Anonymous said...

Hi Joe
I was wondering what gels you are using and what is your opinion on homemade gels.
I experiment with mixing gel myself by combining 3 parts of brown rice syrup (source of complex carbs) 2 parts clover honey (sucrose) and 1 part blackstrap molasses (also sucrose, some minerals but mostly for flavor).
Have you tried to mix gels yourself and what do you think about it?

Thanks,
Myk

 
At July 13, 2009 11:12 AM , Blogger Joe Friel said...

Myk--No, I haven't tried that. Sounds like a good idea, tho. Good luck with it. I use Clif.

 
At July 16, 2009 6:19 AM , Anonymous john cooke said...

dear joel
I found the info very true
i just did IM Austria and had a disastrous race cramping even in the swim and then thru the bike and run legs .At the 150k mark i was also becoming very sleepy and tired as well all new experiences.it was a hot day and unlike previous races I wasn't able to go to the loo so I suspect i was not drinking enough and not taking enough salt .The run just became worse as I could not hold down the gels.I finished but ended up in the med tet with two gbags of fluid and elctrolytes.
still trying to get my nutrition intake right but all your comments
seem to ring true after my IMA experience.

 
At August 2, 2009 12:38 PM , Anonymous Jared Detroit said...

Joe, I've read through this post and your past posts last September on hydration. Great analysis! I just finished my first IM at Lake Placid and lost 5% of body weight. Looking back I don't think I did drink when thirsty.

I believe that your take on hydration and sodium intake is spot on and I will be testing it for myself over the next year before my next IM in Wisconsin.

What is your take on carbohydrate sources? It seems like complex sources like maltodextrin are recommended for long course events but I've heard that having multiple sources of CHO in your drink is better. Maybe adding something like Fructose?

As to who people should listen to, I find that the person that is willing to admit they were wrong in the past and someone that doesn't speak in absolutes is usually the best one to listen to. I think you are a great objective source for nutrition and training advice.

 
At August 2, 2009 1:14 PM , Blogger Joe Friel said...

Hi Jared--Thanks for your post and kind comment. Recent research by Jeukendrup showed that a sports drink with multiple sources of carbohydrate improved uptake by quite a bit when compared with only 1 or 2 and balanced for total calories. Something like 43% if my memory serves me right. The sources in the study were dextrose, sucrose and fructose.

 
At August 24, 2009 8:37 PM , Anonymous sam said...

Joe, thankyou firstly for taking the time to study sport, without you...who knows where we would be. I think that Ironman triathlon has been over thought to the enth degree, and we need to take a step back and go back to basics. Is using just whole foods for nutrition the "optimum" way to fuel during exercise?

Thankyou, Sam

 

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