Novice athletes who are training for marathon running events may be a danger from exercise-associated //hyponatremia (EAH) that can develop from low levels of sodium in the body. The risk to the condition is heightened when the athletes drink excess amounts of fluids during exercises.

Awareness of EAH is increasing, but athletes, coaches, and medical professionals need reliable information on the causes, recognition, prevention, and treatment of this potentially fatal condition.

To address this need, the July/August Clinical Journal of Sport Medicine presents a position statement on current understanding of EAH in endurance athletes. The statement summarizes the conclusions of a panel of medical and scientific experts who met at the 1st International Exercise-Associated Hyponatremia Consensus Development Conference, held in Cape Town, South Africa, in March 2005.

The report summarizes known risk factors for EAH, including low body weight and female sex. Novice athletes and those running at a slow pace—especially with race times over four hours—are also at high risk.

However, the main factor leading to EAH is drinking too much fluid during exercise.

Hyponatremia may occur whether the athlete drinks water or sodium-containing sport drinks. Excessive fluid dilutes the body's sodium level, interfering with the body’s normal regulatory processes.

The key to preventing EAH is to avoid drinking a larger volume of fluid than the body loses in the form of sweat and urine. Formulas are available for estimating hourly sweat loss during exercise—however; a good rule of thumb is to drink only when thirsty.

Increasing sodium intake through sport drinks or salt tablets does not appear to reduce the risk of EAH in those who over drink during exercise.

Planners of marathons and other endurance events can discourage over-consumption of fluid by making sure water stations aren't placed too close
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