Tim Noakes

I must applaud Tim Noakes for authoring--and publisher Human Kinetics for issuing--a true treatise on fluid consumption and overhydration in endurance sports (as the subtitle accurately describes). I was perhaps expecting something on par with a fleshed-out journal or professional magazine article; what I received (thanks to LibraryThing Early Reviewers) was a well-illustrated, textbook-like, nearly 450-page study without, thankfully, a overly pedantic tone. Instead, humanity is present in show more this articulate, well-documented, and ultimately convincing work, as the dedication reveals (and as the author explains in chapter 1). (Note to publisher: The inclusion of explanatory footnotes in callout text boxes is a brilliant design feature.) Folks who are suspicious of the ways Big Industry has affected the food industry (and, concomitantly, advertising, marketing, lobbying, and the like) will particularly appreciate Noakes's criticism of the sports drink industry: When research (or "research," in some cases--Noakes refers to "shaky science") supports the consumption of particular foodstuffs or supplements, we must remain suspiciously vigilant, since businesses exist for the sole purpose of making money. (For a related way in which industry can affect our thinking--and, subsequently, our behavior--see note 1 on p. xvi.) Even if this book would perhaps seem too overwhelming for the casual athlete, I hope its message of moderation in fluid intake during exercise will be heard far and wide. show less

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 show more 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. show less

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 (Principles of Anatomy and Physiology With A Brief Atlas of the Skeleton, Surface Anatomy, ) 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 show more 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 show less

I read Waterlogged in between a couple of trips, and friends and family joked that it looked like I was back in school, lugging around a textbook. I can see why - at over 400 pages, and full of supporting evidence, including graphs and diagrams and charts, Waterlogged physically resembles a lot of the texts I slogged through as a highschooler. But this book was fascinating from start to finish and surpassed any expectations one might have developed based on its appearance.

Dr. Noakes presents show more a detailed look at the history of advice about drinking in endurance athletics and any athletics and then examines the basis for that advice. He reaches back into the historical roots of human beings and examines the evolutionary advantages conferred on human hunters by our ability to delay drinking for some time while we exercised - hunted - in the heat of day. He reviews, and carefully and thoughtfully explains, countless examinations of the impact of fluid intake at various times and in various amounts in connection with exercise, and presents the reader with a somewhat disturbing conclusion: while hydration is essential for health, and important to activity, the way in which we are advised to hydrate ourselves today, supported in large part by the marketing of the sports drink industry, does not correlate to what our bodies actually need before, during and after exercise.

How can this be interesting? Those friends and family asked me as I turned the pages. The story is compelling, and a little terrifying in itself - but Noakes also tells it through stories and the perspectives of those who have both followed and ignored the advice we are currently given. I disagree with the reviewer who said it is for the serious athlete only - I haven't run much more than 4 miles at a go myself, but I found this a fascinating book and I am confident any person who enjoys science and learning, and particularly who enjoys learning about the human body, will find this worth a read. show less