The danger of an inadequate water intake during prolonged exercise

Summary

To prevent thermal injuries during distance running, the American College of Sports Medicine proposes that between 0.83 and 1.65 l of water should be ingested each hour during prolonged exercise. Yet such high rates of fluid intake have been reported to cause water intoxication. To establish the freely-chosen rates of fluid intake during prolonged competitive exercise, we measured fluid intake during, body weight before and after, and rectal temperature after competition in a total of 102 runners and 91 canoeists competing in events lasting from 170–340 min. Fluid intakes during competition ranged from 0.29–0.62 l · h⁻¹; rates of water loss ranged from 0.69–1.27 l · h⁻¹ in the runners; values were lower in the canoeists. Mean post-race rectal temperatures ranged from 38.0–39.0° C. There was no relationship between the degree of dehydration and post-race rectal temperature. We conclude that hyperthermia is uncommon in prolonged competitive events held in mild environmental conditions, and that exercise intensity, not the level of dehydration, is probably the most important factor determining the postexercise rectal temperature. During prolonged exercise in mild environmental conditions, a fluid intake of 0.5 l · h⁻¹ will prevent significant dehydration in the majority of athletes.