I've been itching to read this book ever since it was published last year (2012), but I didn't want to buy a copy because, after all, how often do I need to read about the bad advice so often given to drink water to excess. Now that I am taking an Anatomy and Physiology class ([b:Principles of Anatomy and Physiology With A Brief Atlas of the Skeleton, Surface Anatomy, |3116081|Principles of Anatomy and Physiology With A Brief Atlas of the Skeleton, Surface Anatomy, |Gerard J. Tortora|http://d.gr-assets.com/books/1348237293s/3116081.jpg|2478404]) my interest got high enough to hunt it down. The Flagstaff Public Library was kind enough to buy a copy at my request. I only had to read a little to decide to award it 5 stars because of 1) it's crucial importance, 2) Noakes writing style is delightful, and 3) the research is there to back up what he says.

Once I finally got this book in hand, I didn't want to put it down.

I've finished the book. I will not attempt any comprehensive summary because I could not do justice to it with a summary. There is way too much in here for me to summarize.

Before reading it, I thought it was simple: 'Don't drink too much.' It turns out to be much more complex than that. It is the story of the development of the sports drink industry, of a drink made with common household ingredients: Sugar, salt, and a dash of lemon. It is a story of marketing mixed with bad science, obfuscation more marketing, more bad science, and more obfuscation, repeated endlessly. It is a tale far too familiar - that when you look closely, the same pattern can be found throughout the centuries. A familiar example from a past century is the battle to get doctors to wash their hands. And, by the way, the danger from drinking too much Gatorade, or other sports drink is the same as the danger from drinking too much water. Drinking more Gatorade when over-hydrated, will make it worse. More sodium in the diet does not help either. Not everyone is at equal risk either. (Read the book)

I am astonished at how persistently the repetition of these falsehoods extended over 30 years. Even now, recommendations about exercise performance, hydration, dehydration, and the medical treatment of collapsed runners cling to a version of the hydration myth. It wouldn't be quite so bad if medical personel knew how to treat collapsed runners, but because of the breadth of the misinformation campaign, deaths have followed the application of exactly the wrong medical treatment. (The correct treatment for severe cases is injection of a hypotonic solution.)

That little summary does not do justice to the detailed tale of how this condition became the major health risk for amateur endurance athletes. (Professionals are not at the same risk.) (Read the book.)

Appendix A: Deaths from over-hydration; Many or all are detailed in the text
Appendix B: 31 pages of over-hydration cases documented in the scientific literature
Appendix C: 2 pages of heatstroke cases documented in the scientific literature
32 pages of references in a small font
16 page index ( )

I received this book for free from LibraryThing's Early Reviewers Program.

In the early 2000s, I was talking with a park ranger at the Grand Canyon. He told me he never really had to help anyone with serious dehydration in the Park. Too much water, leading to a salt deficit, was more common in his experience. Ten years later, I got a copy of this book for free. Timothy Noakes explained, at length, why that park ranger was right.

Noakes runs through a massive amount of material relating to human physiology, looking at the biomechanics of running, the hormonal signals that regulate thirst, and all of the associated research. When I first read this book in 2012, I realized I was completely in over my head. I found Noakes' arguments interesting, but I lack subject matter expertise to really be able to assess the details of his arguments. Which is a pity, because I suspect he might have a point, but it is prudent to see what the best counterarguments are, in the best Thomistic fashion.

I'm also cautious simply because this is a field with lots of axes to grind. Like Gary Taubes, Noakes is a bit of a contrarian, and in this book he claims that Gatorade is partly responsible for the idea that we need to drink all the time during exercise, in order to maximize revenues. I don't have an opinion on this. I find it possible, at least, but I'm not interested enough to find out whether it is true. And to be fair, Noakes is suspicious of Gatorade because he realized that the free shoes Nike used to send him colored his views on running injuries (p xvi).

I also don't think it matters to the core argument of the book. Which is extremely reasonable: only drink when you are thirsty. Even when you run or bike for a really long time. As evidence for this, Noakes can point to historical examples like the early and mid-twentieth century practice of marathon runners to not drink anything during the entire race (pp xiii, 38, 210), or the endurance hunting practiced in places as various as the Kalahari and the American Southwest, where you run an antelope to exhaustion and then kill it easily (p 10).

After establishing this recommendation, Noakes looks at the etiology of exercise-associated hyponatremia (EAH) and exercise-associated hyponatremic encephalopathy (EAHE), which he believes are caused by overdrinking during endurance exercise, especially marathon running. Noakes has documented 1600 cases of EAH and EAHE in an Appendix, and he has plotted the incidence over time.

The clear implication of this juxtaposition of charts is that Gatorade is to blame. I'm not sure of this. For example, Noakes doesn't adjust the incidence of EAH and EAHE for the increasing numbers of people participating in endurance sports, which implies a gradual lessening of average fitness, or the numbers of people participating who fall below some threshold of fitness. On the other hand, Noakes does have some evidence that physicians and scientists who got money from Gatorade advocated for the drinking guidelines that he thinks are causing EAH and EAHE in endurance athletes. On the gripping hand, Noakes has some evidence that reducing the availability of fluids during races decreases the incidence of EAH and EAHE (p 303), and that the US military saw a reduction in incidence of both after fluid intake guidelines were changed (p 321).

Noakes also mentions the cases of EAH in the American Southwest, specifically the Grand Canyon, citing a 1999 paper (Backer, Shopes, et al 1999), which brings us full circle, to that anonymous park ranger I met a few years later. Despite the criticisms I have made, I think Noakes is on to something. In part, that is because his core recommendation is pretty sensible. But it is also because where he says something that outrages conventional opinion, I have seen something with my own eyes, or heard with my own ears, evidence that supports Noakes. This increases the probability he is right, but it isn't quite definitive evidence. Since this isn't my field, I'll call that close enough. ( )

Everything you need to know about water and hydration...and more...much more.

Waterlogged chronicles the problem of overhydration in endurance sports. Through tons of scientific research, race injury data, and statistics, Tim Noakes does an excellent job of describing why these problems are on the rise and what to do about them.

This book reads a little like a conspiracy novel because of the topic and connections to big companies trying to sell their "hydration" drinks.

I must warn you that this book is thick. Thick in relation to physical size and writing style. There is a plethora of scientific data that often shot right over my head. Not so much that I couldn't press onward, but enough that I thought I should share with the average reader.

I highly recommend this book to anyone that participates in endurance sports or if you teach athletes that do.

4/5 Stars ( )

After taking a long time to arrive, this book was well worth the wait. It is an incredibly interesting and detailed book about the potential dangers of athletes over-hydrating (a commonly known issue in wilderness medicine, but less widely known amongst laymen). The book is filled with research and statistics to back-up the author's premise that it is more dangerous for serious athletes to over-hydrate than to under-hydrate. There are sections of the book that become overly technical for a lay person, but overall it is a fascinating read, especially for athletes, as it addresses the recent push in the media and sports programs to hydrate oneself to the point of medical danger and decreased performance. This book will make the reader think twice before mindlessly chugging sports drinks and water during competitions, but rather to stay hydrated properly and reasonably. This book is a good read for any athlete (serious or the weekend warrior type) or coach who wants to learn the scientifically-based way to properly hydrate oneself and ones athletes during physical activity. ( )

It is clear that the author has an agenda, in that he feels strongly about the dangers of drinking too much during endurance sports. I'm not qualified to judge the validity of his arguments, but he certainly makes his points well and has a lot of data to back it up. ( )