The NetNutritionist Blog

We all think we need to drink a lot when we exercise, but it can be just as harmful to drink too much as too little. It all depends how much you sweat, says Peta Bee
Germany's Birgit Prinz, right, and her teammates drink water during a break in their soccer semifinals match at the Beijing 2008 Olympics in Shanghai. Photograph: Armando Franca/AP

I have been pedalling hard on a stationary bike for 40 minutes. My thighs are burning and my calf muscles throbbing while sports scientists probe the hi-tech sticking plasters dotted around my body that are designed to assess the quality and quantity of my sweat. Eventually, I am peeled from my saddle to be weighed by Dr Susan Shirreffs, a world-renowned expert in fluid research from Loughborough University's school of sport and exercise science. What might be expected for someone like me - reasonably fit but far from athletic - is that I would be a pound or two lighter than when I started due to the fluid my body expelled during the torturous workout. In hot conditions, it is possible to lose 5lb-8lb in fluid but the scales aren't registering any weight loss in me.

Sweat analysis tests like this are now de rigueur for top athletes. All of Britain's Olympians have undergone a similar assessment prior to Beijing, and footballers from Premiership clubs view them as an essential part of their preparation. According to Shirreffs, the aim of such tests is to determine the rate of fluid lost through sweat so that sports people, and even Joe Joggers like me, can accurately pinpoint the amount they need to drink during exercise to avoid dehydration. "No two people have the same sweat rate," Shirreffs says. "It can vary as much among top athletes as the rest of the population."

My results, which showed that I lost a paltry 315ml an hour of sweat - compared with the 1-2 litres of fluid shed by some people - and a tiny amount of salt (1g in total) suggest I am in the camp that can physiologically cope with drinking very little. Perhaps I was particularly well-hydrated before beginning the trial, it was suggested. But, no, I had run for 30 minutes at lunchtime and drunk only two black coffees and an orange juice before taking up the sweat challenge. Not that the revelations come as a complete surprise.

I have run several times a week since I was 12 and have never needed to carry a water bottle. Only when I have plodded around marathons have I required extra fluid and carbohydrate to keep me going in the later stages.

Periodically my inability to drink and exercise simultaneously (I invariably get a side stitch) has caused me concern because so much emphasis is placed on avoiding dehydration. Yet now there is proof that I never needed much. I wonder how many others are swallowing more than their bodies require? "The majority of people will need up to 500ml of fluid per hour after the first 45 minutes of intense activity," Shirreffs says. "For those who are prone to getting dehydrated, not taking a drink could be disastrous." But, she adds, there is a simple way to tell if you are one of them. Weigh yourself before and after exercise. For every pound you lose, you need to drink around two 10 fl oz glasses (around half a litre) of fluid.

Checking the quality and quantity of your urine can help to tell if you are adequately replacing water loss. Dark and scanty generally suggests it is concentrated with metabolic waste and you need to drink more, although your urine may be darker if you take vitamin supplements (especially vitamin C), so volume is often considered a better indicator.

Staying well-hydrated undoubtedly affects sport performance, and isotonic sports drinks, containing tiny particles of easily-digested carbohydrate that enhance fluid uptake in the gut, are certainly effective. "If the average adult loses 3-4lb of fluid, their performance is seriously impaired," says Louise Sutton, principal lecturer in health and exercise science at Leeds Metropolitan University. "If they lose 7lb, which is possible in the heat, they are likely to get cramps, nausea and experience a 20-30% drop in endurance capacity."

However, in recent years sports scientists have discovered that it is just as risky to drink too much during exercise. Indeed, in many endurance activities, hyponatraemia - or fluid intoxication - is more prevalent than dehydration. Caused by sodium levels and other body salts (or electrolytes) becoming dangerously dilute, hyponatraemia can result in dizziness, vomiting, respiratory problems and fatigue. "During intense or prolonged exercise, the kidneys are unable to excrete fluid as efficiently as normal," Sutton says. "In extreme cases, water is retained, especially in highly absorbent brain cells, and the pressure causes the body to shut down its primary functions, such as breathing and heart rate. Treatment involves a small volume of highly concentrated salt solution. But it can be fatal."

After the 2003 London Marathon, 14 of the runners taken to hospital had hyponatraemia, and a study by Harvard University researchers found that 13% of competitors in the Boston marathon drank enough to cause fluid toxicity. And despite what bottled water and sports drink manufacturers (sports drinks are as likely to cause water toxicity as water) would have us believe, many top athletes drink only small amounts. According to Dr Dan Tunstall-Pedoe, the emeritus medical director of the London marathon, "it's surprising how little elite runners do drink ... they are able to run 26.2 miles at speed with very little fluid on board."

In the British Journal of Sports Medicine, Professor Tim Noakes, from the University of Cape Town and the leading researcher into exercise hyponatraemia, criticised the sports drink industry for positioning their products to the exercising public as "a medicine that must be ingested to prevent heat illness and optimise sports performance. I believe that the body is adapted for conditions of mild dehydration.

"We evolved from hunters - we had to run and chase animals on the hot African plains. We didn't have time to pause for a drink," he says. "Physiologists developed an unproven hypothesis that to become even the slightest bit dehydrated during exercise would kill you. The sports drinks industry then used this bad science to market their products." Runners have died from hyponatraemia, but Noakes says he "has yet to find a death from dehydration in the history of competitive running".

About this articleClose Peta Bee on how much water you actually need to drink while exercising
This article appeared in the Guardian on Tuesday August 19 2008 on p18 of the Comment & features section. It was last updated at 08:23 on August 19 2008.

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By MARK SCHOOFS and RON WINSLOW
August 1, 2008

"Exercise in a pill."

That's how researchers are describing two drugs that apparently mimic the effects of physical exercise on the body, raising prospects of new treatments against diseases, new ways to cheat at sports, and new rationalizations for couch potatoes to stuff themselves at brunch.

The Salk Institute
One of the study's tireless mice during its long-distance workout
In a series of startling experiments in mice, the drugs improved the ability of cells to burn fat and retain muscle mass, and they substantially prolonged endurance during exercise. Using one of the compounds for just a month, even sedentary, couch-potato mice improved their endurance running by a staggering 44%. Some mice that combined a month of exercise with the other drug bolstered their long-distance running by about 70% over untreated mice.

One of the drugs is already in late-stage human trials for other purposes, and the mouse experiments raise hopes for new strategies to protect people against obesity, diabetes and muscle-wasting diseases such as muscular dystrophy.

But underscoring the risks, one of the compounds has been withdrawn from human trials because of toxic side effects, and researchers said that the drugs could easily be abused by competitive athletes to enhance their performance. Researchers have already devised a test to detect them in blood and urine.

A spokesman for the World Anti-Doping Agency said in a written statement that, following policy, it wouldn't say when the test would go into use. But the statement noted that "a number of anti-doping organizations, including the International Olympic Committee, store doping control samples of their events for eight years for potential future retesting." A spokeswoman at GlaxoSmithKline, which developed one of the drugs, said that if athletes get their hands on the drug, "they won't be getting it from us."

The exercise-pill study, published Friday in the journal Cell, was conducted on mice, and it is possible that the drugs may show less benefit, or even none at all, when applied to humans. Still, the underlying genetic switches activated by the drugs appear to be the same in humans and mice.

ENHANCED ENDURANCE

• See video of two mice, one that received one of the drugs tested and another that didn't, exercising on treadmills.
• Health Blog: Experimental Drug Boosts Endurance... in MiceThe researchers examined how the drugs acted on the cellular and molecular level, but they also evaluated the simple ability of mice to run on a treadmill. Unlike humans who may suffer a motivational issue before exercise, "mice are very good at running as far as they can," said principal investigator Ronald Evans, a researcher at the Salk Institute for Biological Sciences, La Jolla, Calif., and the Howard Hughes Medical Institute. "When they get exhausted they just stop running. They can't run any more."

First, Dr. Evans and his team gave the mice a drug known as GW1516, which used to be under development by GlaxoSmithKline as a drug against dyslipidemia, a disorder affecting cholesterol. Side effects forced the company to scuttle it, a Glaxo representative said.

Still, the drug enabled mice to run for more than three hours, compared with less than two hours for untreated control mice. But this drug's effect occurred only when the mice also got regular exercise; sedentary mice got no benefit from the drug. "This is the no-pain, no-gain drug," said Dr. Evans.

Based on research into the genetic switches that control endurance muscle cells, Dr. Evans and his team decided to give the mice a second drug: AICAR, or acadesine, which was recently licensed by Schering-Plough Corp. and is in late-stage trials for the prevention of problems that can occur during coronary surgery. This drug enabled even sedentary mice to run longer, as if they were in good physical condition. "That is the true couch-potato experiment," Dr. Evans said.

Anabolic steroids, often abused by athletes, enhance the performance of fast-twitch muscle cells -- those that provide power and speed. The two drugs being researched are among the first compounds shown clearly to improve the slow-twitch muscle cells used in endurance activities. Whereas fast-twitch muscle cells burn sugar, slow-twitch cells primarily burn fat, which means they could help combat obesity. Previously, resveratrol, found in red wine, was shown to enable mice to run farther, but exactly how it works on slow-twitch muscles isn't clear. A person would also have to drink "hundreds of bottles" of wine to get enough resveratrol to improve athletic performance, said Dr. Evans.

Patients who are bedridden or wheelchair-bound "can't exercise, and this would give them some of the benefits," said Joseph Hornyak, associate professor of physical medicine and rehabilitation at the University of Michigan at Ann Arbor. But the pills would be unlikely to provide all the benefits of real exercise. "People who exercise have lower levels of depression and higher bone density," said Prof. Hornyak. "Whether or not this pill would confer those benefits, we don't know."

The broadest appeal of the drugs may be for gain-without-pain preeners who would sooner pop a pill than strain themselves or a hamstring. Such "off-label" use is "not only a real possibility but a probability," said Dr. Evans.

If the medicine "results in better-looking people, that would be good," said comedian Fran Lebowitz. "All I have right now is a vision of slim, vain, lazy mice."

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By MELINDA BECK

July 29, 2008; Page D1
It's no mystery why Americans are getting fatter. We're expending less energy to work, play, travel and acquire food. And we're taking more calories in.

And how!

New York City's recent law requiring chain restaurants to post calorie counts on menus has revealed some intriguing -- and appalling -- information. Some observations:

How Bad Is It?

A new law is forcing New York City restaurant franchises to post calorie counts on their menus. To gauge New Yorker reaction, WSJ's Matt Rivera hits the streets.
Studies have shown that even dietitians often underestimate how many calories dishes contain, and no wonder. Applebee's Fiesta Lime Chicken packs 1,290 calories. Pizzeria Uno's Individual Chicago Classic (serves one) has 2,310. Who could eat another bite after an appetizer like T.G.I. Friday's Jack Daniel's Sampler at 2,330? Bear in mind that to maintain their present weight, most men should consume from 2,000 to 2,500 calories a day; most women from 1,500 to 1,800, depending on activity level and size.

But It Sounds So Healthy …

Salads come so embellished these days they may as well be dessert. The Pecan-Coated Chicken Salad at T.G.I. Friday's (garnished with mandarin oranges, dried cranberries, glazed pecans, celery and blue cheese) is 1,360 calories. California Pizza Kitchen's Grilled Vegetable Salad is 1,020, or 1,490 with sautéed salmon.

Sandwiches can be a caloric bargain in comparison. At Shea Stadium's Metropolitan Club, the Grilled Chicken Caesar Salad is 807 calories; the Grilled Chicken Sandwich is 340. As veteran dieters know, dressing sends salads to the moon, calorically. Some menus helpfully point out options: Uno's honey mustard has 300 per serving; its fat-free vinaigrette has only 30. Friday's Balsamic Vinaigrette is 590. (Better yet, bring your own dressing "mist," available in a variety of flavors in grocery stores for 2 calories a spray.)

Everything's Relative

Surprisingly, one of the lowest-calorie options on some menus is the unadorned sirloin steak. The nine-ounce sirloin at Applebee's is 310 calories. The 10-ounce at Friday's is 290.

"I actually prefer a roast-beef sandwich to tuna salad -- and it turns out the tuna has almost twice the calories," says New York City Health Commissioner Thomas R. Frieden, who spearheaded the new law. On July 19, the city started fining restaurants that don't comply.

Have It Your Way

Embellishments like mayonnaise, parmesan coating, honey glaze, cheese, sour cream and guacamole add up fast -- which is why fajitas often weigh in at over 1,000 calories. Some restaurants list calories for individual ingredients so you can pick and choose. (Toppings for the Make Your Own Flatbread Pizza at Così range from three calories for spinach to 23 for Asiago cheese.) Others just list a frustratingly wide range. Chipotle's burritos run from 420 to 918 calories, and salads from 155 to 823, depending on what you put in them.

You Gonna Finish That?

The massive calorie counts on some dishes accompany massive portions, which is part of the business model at some restaurants. "The incremental cost of upping the amount of food is very low compared with what consumers will pay," says Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University. You can fight back by sharing that 1,500-calorie salad or taking half home. You can also make it your big meal of the day.

Lightening Up

Some restaurants have had their own sticker shock and started offering lighter options. Così had a nutritionist look for ways to save on every item. Switching to low-fat mayo brought the Così Club from nearly 800 calories to 447. Così's popular Signature Salad (with gorgonzola, grapes, pears, pistachios, dried cranberries and roasted sherry shallot vinaigrette) goes from 611 calories to 371 with reduced-fat dressing and half the cheese. "Having to post this information in New York really focused us on paying attention as well," says Chris Carroll, the chain's chief marketing officer.

Applebee's
Applebee's Fiesta Lime Chicken with Mexi-ranch dressing has 1,290 calories.
Friday's, Applebee's, Uno's--even Taco Bell--have singled out menu offerings that are low fat, low carb, low cal or smaller sized. ("Smaller portions leave more room for appetizers, desserts and, of course, Margaritas!" notes Friday's Right Portion, Right Price menu.)

Starbucks has also cut, on average, 5% of the calories and 15% of the fat from its pastry items and 14% of the calories and 36% of the fat from its drinks in recent years and plans to introduce new, healthier menu items this fall. "We've been hearing from customers all over the country that they are looking for healthy options," says Stacey Krum, a spokeswoman. "They may still want an indulgent treat, but they want to make an informed decision."

Calorie-conscious diners outside New York can get help from Healthy Dining, a San Diego-based program that works with restaurants to develop healthy offerings, thanks in part to a grant from the Centers for Disease Control and Prevention. Its Web site, HealthyDiningFinder.com, lists 55,000 locations that have at least four meals less than 750 calories and 25 grams of fat, though some require a special request to hold a fattening ingredient.

YOUR QUESTIONS ANSWERED

Columnist Melinda Beck answers readers' questions about when it's safe to sit in the sun, the role of vitamin D in health, how to nurse a crying baby without resorting to drugs, and more."A lot of restaurants use a lot of butter or oil in the preparation. Cutting that by half usually doesn't change the taste or the consistency but it dramatically changes the calories and fat," says Healthy Dining Program's president Anita Jones-Mueller. "Some restaurants are really embracing this and creating exciting new items," she adds. "And others are kind of waiting to see if it goes away."

That doesn't seem likely. Even though the New York State Restaurant Association is appealing the city's law, other cities are following its lead. Starting next year, chain restaurants in Seattle will have to post not only calories, but also saturated fat, sodium and carbohydrates on menus. Similar laws are pending in San Francisco and have been proposed in other states and cities. In the meantime, determined dieters elsewhere can find calorie counts posted under nutrition information on some restaurant's Web sites. Sites like www.chowbaby.com, www.thedailyplate.com and www.calorie-count.com have unauthorized calorie counts for restaurants, as do fan sites like Chipotlelovers.com.

Will posting calories prominently really make Americans think twice and order more healthy items? "Anecdotally, you hear constantly about people who've changed their choices," say Commissioner Frieden. "You go into fast-food places and you hear a lot of buzz online."

Elisabetta Politi, director of nutrition at the Duke Diet & Fitness Center, isn't so sure. "Some of our clients know so much about nutrition they could teach the classes, but does that help them control their weight? Absolutely not," she says.

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Artificial hormones in U.S. beef linked to breast cancer, prostate cancer
NaturalNews) There is new concern over evidence that growth and sex hormones in beef can cause genital abnormalities in boys, and early onset of puberty in girls.
British Veterinary Products Committee (VPC) member and chemical expert John Verall was appointed to the government's VPC to represent consumer interests. He recently defied a government gag order, revealing evidence from the study which showed a rise in the rates of breast and prostate cancer in the United States, where two-thirds of all cattle are pumped full of hormones.

Of special concern to Verall are the hormones melegestrol acetate, progesterone, testosterone, trenbolone and zeranol. These hormones are known to disrupt the body's natural balance, causing a number of biological effects. "There is clear evidence of the risk to human health posed by these hormones," Verall said, citing research that showed oestradiol is considered to be a cancer risk. Studies show that 97 of every 100,000 U.S. women have breast cancer, whereas only 67 of every 100,000 European women are afflicted.

Verall added that according to recent studies, children are particularly sensitive to these hormones, which can cause "sudden growth or breast development, even at levels which are difficult to detect in the laboratory."

Currently, the European Union prohibits the use of growth or sex hormones to speed the maturity of cattle and fatten them up, but there are doubts as to whether the ban has been enforced, because there is no testing for hormone residue in beef imported to the EU. The U.S. government has attempted to have the ban lifted, a move supported by Prime Minister Tony Blair and his administration.
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By Serena Gordon
HealthDay Reporter
SATURDAY, April 26 (HealthDay News) — While enjoying a cola or two every day might seem harmless enough, recent research suggests that those tasty drinks could be compromising your bone health.

"There is enough evidence that high consumption of soda and carbonated beverages is associated with somewhat lower bone mass in children, and that's a real concern and people should be aware of it," said Dr. Lawrence Raisz, director of the University of Connecticut Center for Osteoporosis.

The exact mechanism behind the problem isn't clear, but experts believe that drinking soda — particularly colas — affects bone density in several ways. One reason may be that people who drink colas are simply less likely to get enough calcium and vitamin D in their diets, because the soda is replacing more nutritious beverages, such as milk or calcium-fortified juice.

Or, it could be related to the caffeine in colas, because caffeine has been linked to a higher risk of osteoporosis.

The third possible explanation focuses on one of the ingredients found in colas: phosphoric acid. Phosphoric acid can cause an imbalance in the body as the body seeks to neutralize the acid with calcium. If there isn't enough calcium in the diet, the body will take calcium from the bones.

"Phosphate is in milk, but milk also contains calcium and vitamin D. In soft drinks, there is just phosphoric acid and no calcium. Extra overzealous drinking may lead to a phosphoric acid imbalance, and if there's not enough calcium, the body goes to the bones to restore the balance," explained Dr. Primal Kaur, director of the Osteoporosis Center at Temple University Health Sciences Center in Philadelphia.

Low levels of calcium are associated with the development of osteoporosis, a disease that thins the bones so much that they're at risk of fracture. More than half of Americans, especially postmenopausal women, have an increased risk of developing osteoporosis, according to the National Osteoporosis Foundation.

In a study that included more than 2,500 people with an average age of about 60, researchers from Tufts University found that cola consumption by women was associated with lower bone mineral density at three hip sites, regardless of age, menopause, total calcium and vitamin D intake. The women reported drinking an average of five carbonated drinks a week, four of which were colas.

There was less of a problem with decaffeinated cola, but the findings were similar for diet soft drinks. The researchers didn't find an association between cola drinking and lower bone mass in men.

Results of the study were published recently in the American Journal of Clinical Nutrition.

"Moderation is really important. If you really like soft drinks, you don't need to take them out of your diet completely, but limit yourself to one or two glasses" a week, Kaur said.

And, she added, make sure you're getting enough calcium and vitamin D to protect your bone health. Vitamin D needs vary by age, and where you live, so check with your doctor to find out how much vitamin D you should be consuming each day. Kaur said that if you're not getting at least 1,000 to 1,200 milligrams of calcium daily from your diet, you should take a calcium supplement to ensure you're getting adequate amounts of the mineral.

Another important way to prevent osteoporosis, according to Raisz, is to exercise.

"The standard recommendation is a half an hour a day for adults and an hour a day for kids, but anything is better than nothing," he said. "Try to walk at least a half a mile a day, and engage in a weight-bearing exercise of some sort."

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