Electrolytes and Human Health

Every living being is composed of cells. To sustain life, each cell depends upon a steady, adequate intake of two elements: water and nutrients, especially electrolytes. Electrolytes refer to essential minerals critical to health in a number of ways. Acting independently and cohesively, each these minerals called electrolytes – specifically magnesium, calcium, chloride, sodium and potassium – work with water in maintaining fluid and electrolyte homeostasis, in generating and conducting electrical impulses across cell membranes, in nerve transmission, muscle function and cognition. Our body fluids, i.e., blood, cerebrospinal fluid, perspiration etc., are, in fact, a combination of water and dilute solutions of electrolytes. Any imbalance or inadequacy of these elements can result in impaired or slowed muscle function, nerve transmission, cognition and, in severe cases, death.

ELETE offers two electrolyte formulas that are balanced dietary supplements that replace valuable electrolytes commonly deficient in today’s diet. The electrolyte formulas include: ELETE Electrolyte Add-In, a concentrated, liquid electrolyte solution, and Tablytes, a tableted electrolyte replacement formula.

In addition, these formulations are designed to replenish minerals lost in nutritionally significant amounts in sweat1 including: magnesium, critical for energy production and cardiovascular function; chloride, necessary for body-water and acid-base balance2; potassium and calcium, necessary for muscle contraction and impulse conduction in the nerves.3 ELETE’s electrolyte formulations also capture the perfect balance of micronutrients including boron, zinc and selenium, which are important elements found as part of enzymes or required in many enzymatic functions.3

An important, abiding factor in ensuring an optimal level of electrolytes and trace minerals is the bioavailability of the minerals themselves. The minerals and trace minerals in the electrolyte pre-mix formula are contained in ionic form, which translates to improved absorption and assimilation. Ionic elements are designed to easily dissociate in liquid and move to a positive or negative charge. This ionic form is simply a superior, or more bioavailable form, as the macro and micronutrients are already contained in a form that the body utilizes.

Electrolytes and Their Function Within the Body

Simply defined, electrolytes are certain minerals that, in solution, break apart and become electrolyzed3 (hence the term). In other words, these elements are capable of conducting an electrical current.4

In solution, electrolytes, or ions, that separate and carry a positive charge are referred to as cations; ions that carry a negative charge are referred to as anions. Examples of positively-charged ions include: sodium (Na+), potassium (K+), calcium (Ca2+) and magnesium (Mg2+). Negatively-charged ions include: chloride (Cl–), bicarbonate (HCO3–), phosphate (PO4–3) and sulfate (SO42 –).4

Electrolytes, in fact, form the very basis of our being. Within the body, electrolytes are found in both the intracellular and extracellular fluid. Intracellular fluid is the fluid found inside the cells of the body5, extracellular fluid, the fluid found outside of the cells and which includes: insterstitial fluid (fluid occupying the extracellular space outside blood vessels), plasma (extracellular fluid found within the blood vessels), lymph, cerebrospinal and synovial fluid.

Both intracellular and extracellular fluid contain dilute solutions of electrolyte minerals that cells rely on to perform a number of functions. The primary electrolytes found in plasma, for instance, are sodium, then chloride followed by smaller concentrations of bicarbonate, protein, potassium, calcium, phosphate and magnesium.5 Cells (including nerve, heart and muscle cells) utilize electrolytes to carry electrical impulses across cell membranes to other cells and to regulate the activity of the nervous system and of the muscles, including the heart.

The kidneys constantly regulate fluid absorption and secretion in addition to continually calibrating electrolyte levels within the body: they will filter electrolytes such as sodium and potassium, for instance, and either use them according to the body’s need at that moment or will excrete them via the urine or feces if there is an excess of that element at that particular moment.

Factors Affecting Electrolyte Balance

Every second of every day, our bodies rely on electrolytes just to support normal physiological functions, and, as a result, we experience small, daily losses of electrolytes. For instance, the average loss of fluids and electrolytes through perspiration can total 600 milliliters (ml). In respiration, this amount is 400 ml; in feces, 200 ml and in urination, 1300 ml.2

Other factors such as pregnancy, poor diet, dehydration, use of diuretics, disease, exertion, vomiting, diarrhea, trauma and excessive perspiration significantly increase one’s need for electrolytes.

To ascertain the degree of electrolyte loss occurring as a result of strenuous physical activity, Mao et al measured electrolyte loss from thirteen soccer-team players and 100 sedentary students from the same high school for a period of eight days. Mean electrolyte losses gathered from sweat and urine samples following a one-hour game measured: sodium, 1,896 milligrams (mg); potassium, 248 mg; and calcium, 20 mg.6 These results demonstrate that the loss of electrolytes through excessive perspiration is

significant and, over time (with the exception of sodium, levels of which are luxuriantly provided within the American diet), these losses can have a negative impact.

Prominent signs of an electrolyte imbalance include: muscular weakness, slowed nerve conduction and muscle function, general weakness and apathy.

Diet As An Unreliable Source of Electrolytes:

The importance of electrolyte replacement formulas stem from the fact that unfortunately, modern diets are no longer a reliable source for the replenishment of valuable electrolytes. Large-scale dietary surveys consistently corroborate the fact that with the exception of sodium, many important minerals including magnesium, calcium, chloride, potassium and important trace elements are not replaced.

In the case of magnesium, for instance, a survey conducted by Gallup revealed that 72 percent of adult Americans are falling short of the Recommended Dietary Allowance (RDA). The survey further revealed that 55 percent of all adults are consuming three- quarters or less of the RDA, while 30 percent are eating less than half the required amount of the mineral.7 Several studies have also supported this finding in self-selected diets in Europe and Asia as well.8 There are several factors that account for this suboptimal intake including the use of synthetic fertilizers that only replace two or three minerals ( primarily nitrogen and phosphate) rather than a comprehensive balance of minerals; the use of synthetic pesticides; food refining techniques that strip minerals, vitamins and nutrients from foods (e.g., heat processing, grinding, removal of nutritionally dense components); use of artificial colors, flavors, preservatives and municipal water supplies that are soft, i.e., poor in magnesium, calcium, etc. Another factor accounting for this suboptimal intake is the presence of certain metabolic conditions in individuals such as hypertension, pregnancy, osteoporosis, stress and trauma that also increase one’s requirements for specific elements.9

Therefore, based on how micronutrients affect fluid balance, muscle contraction and nerve conduction, supplementation of ionic electrolytes⎯magnesium, calcium, chloride, potassium and some sodium⎯as is found in ELETE’s line of dietary supplement may be warranted.

Magnesium

An essential mineral, magnesium(Mg) is the fourth most abundant cation in the body and is an intracellular ion.10 Nearly half the Mg found in the body is contained within the bone.11

Mg is an element needed to activate enzymes that are important for protein, electrolyte and carbohydrate metabolism, in DNA production and function and in the utilization of other essential minerals including calcium.8 Mg modulates the electrical potential across cell membranes, which allows nutrients to pass back and forth. It helps in the production of energy by transferring the key phosphate molecule to adenosine triphosphate (ATP), a high energy source generated by the cytochrome system11, in muscle contraction and relaxation, in nerve conduction, in protein synthesis, and in many biochemical reactions as a cofactor to enzymes.8

Mg is important is maintaining resistance to infection, in protecting against cardiovascular, kidney and bone disease and in assisting in meeting additional needs as a result of emotional and/or physical stress.8 There are over 200 published clinical studies showing the need for Mg.12 These studies have shown Mg to be helpful in migraines, high blood pressure, asthma, angina pectoris, coronary artery disease, cardiac arrhythmias, certain types of musculoskeletal disorders, epilepsy, chronic fatigue syndrome, mitral valve prolapse, anxiety, panic disorder, pre-menstrual syndrome, pre- eclampsia as well as many other medical and psychiatric conditions.12

Several studies have been conducted examining the effect of Mg supplementation on muscular work performance.13 Studies have demonstrated a sustained fall in Mg plasma concentration following strenuous physical exercise.13 Whereas decreased endurance capacity has been observed in animals fed Mg deficient diets, Mg repletion has been shown to have a significant effect in athletic performance.13 In moderately-trained athletes, Mg supplementation resulted in a significant decrease in blood pressure, heart rate and oxygen consumption indicating that Mg supplementation effectuates an improvement in cardiorespiratory performance.13 Another study found that triathletes taking 390 mg of Mg per day demonstrated reduced swimming, cycling and running times.14 It has been hypothesized that this effect is due to Mg increasing glycogen synthesis or sparing glycogen in muscle, thereby conserving energy more efficiently.15

Inadequate Mg status (both with and without symptoms) has been associated with several symptoms including gastrointestinal tract abnormalities associated with malabsorption or excessive fluid and electrolyte losses and renal dysfunction with defects in cation reabsorption.16 Other symptoms of inadequate Mg status include: nausea, muscle weakness, constipation, urinary spasms, menstrual cramps, sensitivity to loud noise, anxiety, insomnia, premenstrual irritability, heart palpitations, arrhythmias, angina due to spasms of the coronary arteries, high blood pressure and mitral valve prolapse.12,16 Because certain minerals and trace minerals work in a cohesive fashion (i.e., certain elements increase the efficacy of others), a deficiency in Mg, according to Whang, can also lead to a disruption in the reuptake of potassium once dehydration has occurred17– an effect that can have very negative health implications (i.e., cardiac function, acid-base and body-water balance) and as it relates to athletic performance (i.e., energy, endurance, muscle performance).

Many commercially available sports drinks do not contain Mg, thereby making the common purpose of these sports drink products, which is rehydration, completely obsolete.17 ELETE’s line of electrolyte formulations are designed to replenish the body’s concentration of Mg plus other macro and micro minerals in a highly available and assimilable form. This formulation provides Mg in sufficient levels to assist individuals in meeting the recommended daily allowance (RDA) for Mg (280 mg/day for women, 350 mg/day for men).

Chloride

Chloride (Cl) is a naturally-occurring element found abundantly in nature.18 Within the body, though, it is an inorganic ion that is contained in extracellular fluid along with sodium.19 Cl makes up about .15 percent of our body weight 19 and is mainly found in the extracellular fluid along with sodium.20 It occurs in plasma in concentrations of 96 to 106 mEq/liter (1mEq of chloride is 35.5 mg).16 The highest amount of Cl can be found within the red blood cells and, in a more concentrated form, in cerebrospinal fluid and gastrointestinal secretions.18

As one scientist observed many years ago, our cells contain the same elements and concentration of elements nearly identical to those found in early Precambrian seas.18 Science clearly demonstrates that early life forms developed their structure and catalytic abilities using minerals and trace minerals found in these ancient seas.21 In his paper, “Evolutionary Events Culminating In Specific Minerals Becoming Essential for Life,” Nielsen states, “The mineral elements incorporated in the first primitive organisms, therefore, most likely reflected the mineral element concentrations in the sea water where they evolved.”21 The average concentration of Cl contained in sea water is 18.98%18. This recalls the earlier fact that Cl is the most abundant anion found in plasma5 and that concentrations of this element is closely regulated by the kidneys.

According to the National Academies of Science, Cl “is essential in maintaining fluid and electrolyte balance.”16 It is involved in body water balance and acid-base balance.2 Cl is intricately involved in the exchange of oxygen and carbon dioxide within the red blood cells. Referred to as the chloride shift, when red blood cells are properly oxygenated, Cl will circulate from the red blood cells to the plasma where bicarbonate will leave the plasma and shift to the red blood cells.2 This shift is essential in maintaining homeostasis or equilibrium within the body.2 Cl also helps generate the osmotic pressure of body fluids20 and works with the other electrolytes in maintaining nerve transmission and normal muscle contraction and relaxation; in stimulating the liver to act as a filter, separating waste and then eliminating it from the body; in assisting in bone and joint support and in distributing hormones.20

Cl is also critical for digestion. It combines with the hydrogen ion in the stomach to form hydrochloric acid (HCl), or gastric juice.2 As we age, our bodies can secrete less HCl which can impair the absorption and assimilation of many of the nutrients such as magnesium and calcium. Supplementary forms of Cl, though, can stimulate the production of HCl, necessary for the absorption and assimilation of minerals and nutrients found in the foods we eat and the supplements we consume.

Cl is easily absorbed in the small intestine and is excreted via the urine and in perspiration.19 Cl loss mirrors that of sodium loss, therefore, conditions that deplete Cl include: chronic diarrhea and/or vomiting, excessive perspiration, trauma and renal disease16. Symptoms of a Cl deficit include: hair and tooth loss, poor muscular contraction and impaired digestion.19 In the case of a severe Cl deficiency, hypochloremic metabolic alkalosis can result, which is the state of the body fluids becoming too alkaline, characterized by nerve and muscle hyperexcitability and slow and shallow breathing.2 A potassium deficiency will also occur in conjunction with Cl loss.2

Calcium

Calcium (Ca) is an essential nutrient that is primarily stored in the bone (approximately 99 percent).11 The lion’s share of attention this mineral receives is in conjunction with its role in bone density, which is, in fact, the major function of Ca. It, together with phosphorous and other minerals and trace minerals, helps to build and maintain bone.22 However, Ca also serves in several important intracellular functions as well.

Less than one percent of the body’s Ca is contained in extracellular fluid and this minute concentration is carefully regulated by calcitonin and parathyroid hormone.2 Ca is present in three different forms in the body: ionized, bound and complexed.2 Nearly half of the plasma Ca is free, ionized Ca. Slightly less than half the plasma Ca is bound to protein, primarily albumin, and the remaining percentage is combined with other elements such as phosphate, citrate and carbonate.2 Only the ionized Ca is physiologically important. For the body to utilize Ca to perform its physiologic functions, the Ca must be in its free, ionized form.2 The Ca and other elements in this product, as well as other ELETE products, are contained in ionic form, thus resulting in improved absorption and assimilation.

Maintaining Ca homeostasis is essential to life. Levels of intracellular Ca will be maintained at the expense of bone Ca. If there is not enough dietary calcium to support Ca blood levels, the parathyroid gland will release parathyroid hormone, which will increase the intestinal absorption of Ca and leach Ca and phosphorous from the bones. So, although the majority of Ca is contained in the bones, blood and cellular concentrations of this mineral are maintained first.23

Among Ca’s intracellular functions are: protein and fat digestion, energy production, normal nerve conduction and muscle contraction and membrane permeability.11,16 Ca is keenly involved in the contraction of heart muscle2 and it affects the absorption of other nutrients including B-1211 and iron.19 It also plays an important role in blood clotting process by converting prothrombin into thrombin.2 Ca also wards off an accumulation of excess acid or alkali in the blood.19 It is also involved in the activation of several enzymes including lipase, which breaks down fats for utilzation by the body and exerts a sedative effect on nerve cells.2

As we age, the ability to absorb and assimilate Ca decreases. During infancy and childhood, up to 75 percent of the Ca ingested may be absorbed, whereas an adult might use only 20-40 percent of dietary calcium in his or her body.16 According to the National Academies of Science, the average adult excretes 100 to 250 mg/day of Ca through urine, however, this amount can vary among persons eating self-selected diets.16 Gastric hydrochloric acid assists in Ca absorption as the duodenum is the site for absorption of calcium( see Cl).20

Prominent signs of Ca deficiency include: brittle nails, aching joints, elevated blood cholesterol, heart palpitations, insomnia, muscle cramps, nervousness, rickets, tooth decay, rheumatoid arthritis, cognitive impairment, depression and in severe cases, convulsions and delusions.19

Considering Mao et al’s earlier findings measuring Ca losses that occurred through strenuous activity,6 it is important to note that ELETE’s electrolyte formulations (see above) provide small amounts of Ca, in its ionic form, to assist and support the body in numerous skeletal and extraskeletal functions. However, the amounts of Ca vary from product to product. Please refer to the product’s label for the exact amount of calcium.

Potassium

Potassium (K) is the primary cation found within the cells. Ninety-seven percent is found in the intracellular fluid and 2 to 3 percent is found in the extracellular fluid (e.g., intravascular and interstitial fluids).2 The normal concentration of K in cell water is 145 mEq/liter (1mEq of K is 39 mg)16 while the normal serum K range is 3.5 to 5.3 mEq/L.2 This range is carefully regulated by the kidneys.

Within the body, K regulates fluid balance within the cells, contributes to nerve impulse transmission, skeletal and smooth muscle contraction and the maintenance of normal blood pressure.11,16 Research has demonstrated that a low potassium intake, which is quite common in the United States, tends to elevate blood pressure.24 In conjunction with sodium, K regulates water balance and acid-base balance within the blood and tissues.24 It is able to enter the cells more easily than sodium and will instigate the brief sodium-K exchange across the cell membrane.24 During muscle contraction, sodium and K are exchanged.11 K is also very important for contraction of the myocardium.16 Too little K changes the conduction rate of the nerve impulses and can weaken heart muscle, thereby causing it to beat irregularly.2 It is a catalyst for protein and carbohydrate metabolism,11 is involved in cellular energy production, deposits glycogen (the body’s main fuel source) in liver cells, regulates the osmolality of intracellular fluids and is also important for normal growth and to build muscle.16,24

Studies have demonstrated that K reduces mean systolic blood pressure. Diets high in K correspond with a decreased risk in stroke mortality. It also been reported that K reduces vascular and plasma lipids and can be of benefit in the protection against cardiovascular disease.25

In muscle performance, contracting skeletal muscle cells release K. Ongoing muscular contraction, followed by an accompanying release of K can lead to muscular fatigue.26 Diuretic drugs, illness (e.g., vomiting, diarrhea) and abuse of laxatives can further exacerbate a K imbalance in certain individuals. Supplemental amounts of K, however, may alleviate weakness and fatigue in elderly persons or persons following weight-loss programs.24 Repletion of this mineral may also be required after an individual has experienced heavy fluid losses, such as in perspiration, for example. During perspiration, as water, sodium and other electrolytes are lost from the body, the ultimate damage, reports Schauss, results when K moves out of the cells with cell water.11

The minimum requirement for K as set by the National Academies of Science is 1,600 to 2,000 mg (40 to 50 mEq) per day.16

Sodium

Sodium (Na) is the primary cation found in extracellular or intravascular fluid and is the main regulator of extracellular fluid volume.16 In addition to this, Na maintains acid-base balance, regulates the osmolality of vascular fluids and maintains the membrane potential of cells.16 The normal concentration of sodium in the extracellular fluid is 135 to 146 mEq/L; in perspiration, it is 50 to 100 m Eq.2

The shifting of Na and K across cell membranes helps to create and electrical potential that enables the muscles to contract and nerve impulses to be transmitted: Na shifts into cells as K is shifted out in order to maintain water balance and neuromuscular activity.2

Another important function of Na is that it influences the solubility of the other blood minerals, thus preventing a build-up of certain deposits within the bloodstream.19

Some Na is stored in the bones and is made available as it is needed. Na can be lost with excessive perspiration and with vomiting and diarrhea. Thirst is activated by Na and occurs after the total level of body water is reduced.27 Even slight dehydration can reduce the blood volume thereby triggering the thirst response.27 It is for this reason that thirst is a poor indicator of fluid replacement.27 Thirst can result in the replenishment of water, but not of Na, which is important for osmolality.2 Drinking water alone can lead to “water intoxication.” In such a situation, water goes into the cells and causes swelling, which is characterized by headaches, weakness, loss of appetite and poor memory.

During strenuous exercise or competition, hyponatremia, which is measured as a blood Na concentration below 136 mmol/L, can occur.27 Hyponatremia can sometimes be diagnosed in persons at rest. However, individuals with low Na levels do not necessarily have the symptoms of hyponatremia. Hyponatremia is characterized by weakness and/or disorientation. In very serious cases, it can result in rapid neurological deterioration, cardiovascular instability and seizures.27

The use of Na during and/or following strenuous exercise or competition, especially in long-endurance events, may be warranted. Hyponatremia can occur if too much water and too little sodium is consumed (see above). By adding a small amount of Na to water, it can speed gastric emptying and water absorption.27

Conclusion

Electrolytes lost as a result of profuse sweating, illness, diuretic use, etc. must be replaced in the diet. Unfortunately, most sports electrolyte drinks found in today’s marketplace are comprised mainly of sugar and sodium and lack the comprehensive balance of other valuable minerals and trace minerals, which the body uses for a variety of physiologic functions.

The ELETE line of electrolyte formulations supplement the diet with critical electrolytes including magnesium, chloride, calcium and potassium balanced with other important micronutrients lacking in most sports drinks and gels. To further enhance the efficacy of these products and the elements and trace elements contained therein, all of these formulas contain the natural balance of micronutrients as found in Utah’s Great Salt Lake. Some of the natural micronutrients contained in this formulation include: zinc (associated with maintaining normal taste and smell, helps synthesize DNA and RNA), selenium (acts as a powerful antioxidant), and boron (important for brain function and bone density), to name only a few. The combined effect in terms of micronutrient content and electrolytes will support a healthier electrolyte ratio, which, in turn, can positively impact overall health and well-being.

In addition, the elements and trace elements in this formulation are ionic, i.e., the minerals will easily become ions in liquid form, thus allowing for optimal absorption and assimilation within the body.

References:

Brotherhood JR. Nutrition and sports performance. Sports Med 1984 Sep- Oct;1(5):350-89.

Kee J.L., Paulanka B.J. Fluids and Electrolytes with Clinical Applications, Delmar Publ.:Albany, NY, 1994.

Nielsen M. Ions: The Body’s Electrical Energy Source. Mineral Resources International, 1995.

Horne M.M., Swearingen P.L. Fluids, Electrolytes, and Acid-Base Balance, 2nd Ed. Mosby-Year Book, Inc.:St. Louis, Missouri, 1989.

Fluid and Electrolyte Therapy [online]. (No date). Academy of Health Sciences, U.S. Army, Dept. of Clinical Support Service, Pharmacy Branch. Available from: http://www.cs.amedd.army.mil/dcss/phar/y7fluid.htm (24 November 2001).

Mao IF, Chen ML, Ko YC. Electrolyte loss in sweat and iodine deficiency in a hot environment. Arch Environ Health 2001 May-Jun; 56(3):271-7)

Landy, Liz. “Gallup Survey Finds Majority of American Diets Lack Sufficient Magnesium – At Potential Cost to Health,” Searle News, Sept. 21, 1994

Seelig, M.S. Human Needs for Magnesium Are Not Met By Most People. Mineral Resources International, 2001.

Marier JR. Magnesium content of the food supply in the modern-day world. Magnesium 1986;5(1):1-8)

Briggs, S. Magnesium-A Forgotten Mineral. Health and Nutrition Breakthroughs, New Hope Publications, November 1997.

Schauss, A. Minerals and Human Health: The Rationale for Optimal and Balanced Trace Element Levels. Life Sciences Press: Tacoma, Wash., 1997.

Haas, E.M., Magnesium [online]. (No date). HealthWorld Online. Available from: http://healthy.net/as/templates/Article.asp?PageType=Article&ID=2060.

Schachter, M. The Importance of Magnesium to Human Nutrition, http://www.healthy.net/asp/templates/Article.asp?PageType=Article&Id=541

Rayssiguier, Guezennec CY, Durlach, J. New experimental and clinical data on the relationship between magnesium and sport. Magnes Research (1990) 3(2),93-102.

Athletic Performance [online]. (No date). Health Notes. New Hope Communications. Available from: http://www.healthwell.com/healthnotes/Concern/Athletic_Performance.cfm?path= hw

Seelig, M. Consequences of Magnesium deficiency on the enhancement of stress reactions; preventive and therapeutic implications (a review). J Am Coll Nutr, 1994;13(5);429-446.

National Research Council. Food and Nutrition Board. Recommended Dietary Allowances.10th ed. National Academy Press: Washington, D.C., 1989.

Whang, R. Electrolyte and water metabolism in sports activities. Comprehensive Therapy, Vol. 24, January 1998, pp.5-8

Schauss, A. Cl-Chlorine: What’s The Difference? 1996: Tacoma, Washington. American Institute for Biosocial Research.

Dunne L.J. Nutrition Almanac, 3rd Ed. McGraw-Hill Publ.:New York, 1990.

Haas E.M. Cl [online]. (No date). HealthWorld Online. Available from:

http://www.healthy.net/asp/templates/Article.as?Page=Article&id=2050

Nielsen F.H. Evolutionary events culminating in specific minerals becoming essential for life. Eur J Nutr, 39:62-66 (2000).

Nielsen, F. Balderdash and realities of health and performance claims for supplements as exemplified by Ca, chromium and vanadium, Proc of North Dakota Acad of Science, 53:78-82, 1999

Haas E.M., Ca [online].(No date). HealthWorld Online. Available from: http://www.healthy.net/asp/templates/Article.asp?PageType=Article&Id=2019

Haas E.M., Potassium [online].(No date). HealthWorld Online. Available from:

http://www.healthy.net/asp/templates/Article.asp?=Article& ID ?

Medical Economics Company. PDR for Nutritional Supplements 1st Ed. Medical

Economics Company: Montvale, NJ, 2001.

McKenna MJ. Effects of training on potassium homeostasis during exercise. J

Mol Cell Cardiol,1995, Apr;27(4):941-9.

Maffetone, Philip. Water and electrolytes [online]. (No date). Available from:

http://www.rrca.org/publicat/wat.htm

These statements have not been evaluated by the U.S. Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

This technical article is for information purposes only. The research presented and cited in this article is not an endorsement of ELETE products.

Balancing Act (What Are Electrolytes?)

By Matthew Tim Anderson, B.I.S.

Electrolytes are responsible for maintaining proper fluid balance within cells.

Many people hear the word “electrolytes” but have no idea how necessary they are to good health. Electrolytes are minerals capable of transmitting electrical charges within fluids.

This function, as well as the reciprocal relationship between water and electrolytes, is extremely important since 50 to 75 percent of the average human body is made up of water and other fluids.

Within our bodies, electrolytes are transmitters for the 100 million or so messages per second relayed within the nervous system. Electrolytes are necessary for all brain functions: Without these electric transmissions, the brain could not stay in control of the body’s many functions. Every time one of our thousands of muscles contracts or relaxes, electrolytes are in use. They are responsible for maintaining proper fluid balance within the cells. In fact, every one of our trillions of cells relies on electrolytes for the transportation of nutrients and waste.

In short, electrolytes are responsible for the basic metabolism of every cell in the body. It makes sense then that we can optimize health and vitality by maintaining optimal levels of fluids and electrolytes in our diets.

Our bodies normally excrete water and electrolyte solutions at an average daily rate of 1,300 millitres (ml) through urination; 600 ml through perspiration, and 200 ml through feces. Other factors that increase our need for electrolytes include pregnancy, poor diet, dehydration, use of diuretics (including coffee and other caffeinated drinks), disease, exertion, vomiting, diarrhea, trauma, and excessive perspiration. When our bodies thirst for water, we almost certainly also crave electrolytes.

Last September, the unfortunate death of a four-year-old Utah girl, reportedly caused by forced consumption of excessive water, made international news. In fact, it was not water that caused her death, but, rather, the dilution of essential electrolytes. There have also been numerous high-profile cases among top athletes who have died suddenly of cardiac arrhythmias, usually linked to electrolyte instability. Prominent signs of electrolyte imbalance or deficiency include muscle weakness, cramps, swelling, slowed nerve conduction and muscle function, and general weakness and apathy.

Electrolytes are essential for people of all ages and all physical conditions. Deficiencies or imbalances are almost universal, but are difficult to reverse by diet alone since our foods are generally overprocessed and grown in mineral-deficient soils. Fortunately, electrolyte balance can be easily restored by taking quality supplements. Look for supplements at your local health food store with a balance of major electrolytes and other trace elements, adequate concentration, and minerals that are either ionic or easily become ionic in water. Ask your health food store personnel for recommendations and notice the difference improved electrolyte balance can make to your health.

Major Electrolytes

The body’s major electrolytes are sodium, potassium, calcium, and magnesium as positively charged ions (cations), and chloride, bicarbonate, phosphate and sulphate as negatively charged ions (anions). Any mineral or trace element in ionic form is capable of functioning as an electrolyte; however, it is imperative to understand that not all of the various forms of minerals (elements) or trace minerals available as supplements are capable of becoming electrolytes within in the body.

Minerals become electrolytes in solutions when they are completely disassociated from their compounds. In other words, minerals become electrolytes or ionic when they are truly dissolved, not just suspended in liquid. As ions, they are either missing or have an extra electron, giving either a positive or negative charge. Only minerals that are already ionic, or those capable of becoming ionic through digestion, can perform the vital roles of electrolytes.

© 2003 by Alive Magazine. Reproduced with permission.

Dehydration — An Imbalance of Water and Minerals 100% Preventable — If You Know What To Do!

by Chris D. Meletis, N.D.

Dehydration results from the loss of water and important electrolytes from the body, including potassium, sodium, chloride, and many other minerals that are often overlooked. The very functioning of essential organs like the brain, kidney, heart and nervous system can’t function without sufficient water or minerals. In third world countries, millions of people die each year from dehydration, particularly susceptible are children and the elderly. But even in North America people suffer unnecessarily and even when people aren’t actually ill from dehydration, it can really affect quality of life and performance.

Noteworthy is that water makes up 70 percent of our muscles and about 75 percent of our brains. Thus, it is not surprising that as minerals and water become depleted that muscle aches and cramps, fatigue and thinking can be affected. Research shows that dehydration can diminish thought processes and memory, thus adversely affecting global quality of life. This should not be surprising considering that an imbalance in just one mineral can actually lead to substantial biochemical imbalances; thus maintaining and replacing the full array of minerals and trace minerals in one’s diet daily is important, let alone during times of strain on your body’s systems that can cause dehydration.

There are many causes of dehydration; indeed, everyday we lose about two cups of water from just breathing, so if it is not replaced, a fluid and electrolyte imbalance will occur. Dehydration causes fall within four basic categories:

Common Causes of Potential Dehydration*

Sweating – Fever, Exercise, Excess exposure to heat (heat exhaustion/heat stroke)
Vomiting – Ulcers, Food Poisoning, Flu, etc.
Diarrhea – Gastroenteritis, Flu, Food Poisoning, Bowel Disease
Insufficient Intake – This can arise from not consuming adequate quantities of water and minerals or a relative deficiency due to excess loss.
*It is essential that the cause of the dehydration is addressed.

I routinely coach my patients to focus on prevention when it comes to dehydration.

The reality is that dehydration happens more frequently than most of us realize. How many of you have suffered from dry lips and mouth, skin that is flaky, and a swimming sensation in your head when you have forgotten to drink sufficient water? Well, one or more of these symptoms are very prevalent for tens of thousands of people in the North America alone.

In fact, on a hot humid day, an active person can become dehydrated in just 15 minutes. So, how do you avoid getting dehydrated? Well, here are two specific clues:

Get enough water
Consume your minerals: sodium, potassium, chloride, calcium, and magnesium
Minerals – The Spice of Life and an Essential Consideration for Dehydration Treatment

Sodium
Salt— plain and simple; That is why after sweating you crave salty food.
Potassium
Most Americans don’t get enough. The average intake is only half as much as sodium. A healthful intake is 5 times more potassium, than sodium, which is easily obtained by eating a more vegetable and fruit-based diet.
Chloride
The mate to both sodium (NaCl) and potassium (KCl), it is essential to keep these items in proper balance.
Calcium
This mineral is essential for proper cardiac and muscle function; if too low, one can get muscle cramps.
Magnesium
When low, muscle spasms can occur. This mineral is crucial for maintaining a healthy airflow and helping to keep blood pressure balanced.
Trace Minerals
The forgotten minerals; just because they are trace and small, they are lost also when one gets dehydrated. Replacing them as well can help maintain overall health and optimal functioning and performance.
If you are athletically inclined, avoiding dehydration takes on additional significance.

Not only are you at a higher risk, dehydration can really decrease your performance and endurance, thus dulling your performance edge.

There are two basic levels of dehydration that might be treated at home. It is important to remember dehydration can be serious. Here are some signs of dehydration and the level of related severity:

Frequent Signs of Dehydration*

Mild – (Safe to treat at home as long as it doesn’t worsen)
Thirst
Dry Lips
Inside of mouth slightly dry
Moderate – (Children under 12 should see a physician immediately)
Thirst
Very dry mouth
Eyes sunken
Fontanelles sunken (The soft spots on infants’ heads)
Tenting (Pinch and lift skin slightly – it doesn’t bounce back readily)
Severe – (This requires hospitalization to rapidly reverse the dehydration via IV therapy)
All other signs of moderate dehydration
Rapid and a weak pulse (Often over 100 beats per minute)
Cold hands and feet
Breathing is rapid
Lips may be blue
Person may be lethargic, confused, or apathetic
*When in doubt get medical attention, it is always important to be cautious.

Though the symptoms described above seem ominous, the important thing to remember is that these symptoms occur when dehydration is allowed to occur and is not treated in a rapid fashion. Remembering that the very young and older adults are more susceptible to suffering from dehydration and a more rapid and serious progression of symptoms requiring even more close attention, here are a few points of review that are helpful tips to remember:

Practical Tips to Avoid Dehydration:

Drink plenty of fluids—consume 8 glasses of 8 ounces of water daily

Sports drinks can provide carbohydrates, fluid and minerals

Limit or avoid caffeinated beverages and alcohol—they both increase dehydration

Outside clothing on warm days should be light, absorbable, and loose-fitting

Avoid carbonated beverages that can bloat and give sense of fullness, limiting fluid intake

Use sunblock, staycool, and seek the protection of shade whenever possible

Consuming your water and replacing your minerals is the essential first step when treating dehydration. Yet the best bet is to get your daily dose of minerals and water daily, so you will be better prepared for potential dehydration risks. Researchers have shown that pre-loading, treating during and after are the best ways to maintain proper hydration.

References:

Clap AJ et al., A review of fluid replacement for workers in hot jobs. AIHAJ 63(2):190-8, 2002.

Burker LM., Nutritional needs for exercise in the heat. Comp Biochem Physiol A Mol Integr Physiol 128(4):735-48, 2001.

No Listed Authors, Position of dietitians of Canada, the American Dietetic Association, and the American College of Sports Medicine: Nutrition and Athletic Performance. Can J Diet Pract Res 61(4):176-192, 2000.

Electrolyte Additives for Hydration

By Paul S. Auerbach, MD, MS, FACEP, FAWM

The current issue of the journal Wilderness & Environmental Medicine, published by the Wilderness Medical Society, has a number of very interesting articles of significance to the layperson outdoor medicine enthusiast.

“Effects of an Electrolyte Additive on Hydration and Drinking Behavior During Wildfire Suppression,” by John S. Cuddy and his colleagues (WEM volume 19, pages 172-180, 2008), describes a study designed to compare the effects of a water plus electrolyte solution versus plain water on changes in drinking behaviors, hydration status, and body temperatures during wildfire suppression activities. In this particular study, eight participants consumed plain water, and eight participants consumed water plus an electrolyte additive (Elete by Mineral Resources, Ogden, Utah) that contained magnesium, sodium, chloride, potassium and sulfate. The participants were provided specially outfitted backpack hydration systems with three-liter capacity from CamelBak (Petaluma, California).

During the measurement period, the participants were monitored for volume of fluid consumed, body weight, core, and skin temperatures. Work output was measured, as was the environmental temperature. The results indicated that all things being equal, the major difference noted between the water group and the water plus electrolytes group was that a remarkably lower fluid consumption (approximately 3.3 liters per day) was noted in the water plus electrolytes group. This suggests that supplementing water with electrolytes might reduce the amount of fluid necessary to transport and consume during extended activity. This would minimize excessive weight, which in and of itself might contribute to a lessening of fatigue.

In this study, the amount of fluid consumed was at the discretion of the participant, so was presumably driven by thirst. It would be very interesting to replicate this study in other situations where rehydration is important, such as high altitude travel, competitive sports, and recreational sports. It would be important to control for as many variables as possible, such as beverage temperature, taste, food intake, and so forth. It would also be useful to determine if this information has any applicability in a survival situation.

Health Matters – Health Expert Biography

Paul S. Auerbach, MD, MS, FACEP, FAWM

Professor of Surgery in the Division of Emergency Medicine at Stanford University Medical Cent Officer and Chair of the Medical Advisory Board for Healthline; A Founder of the Wilderness M Fellow, American College of Emergency Physicians; Fellow, Academy of Wilderness Medicine

Medical Specialty: Emergency Medicine
Healthline Blog: Medicine for the Outdoors

Dr. Paul S. Auerbach is Professor of Surgery in the Division of Emergency Medicine at Stanford University School of Medicine. Dr. Auerbach is a founder and past president of the Wilderness Medical Society, editor of the definitive medical reference text Wilderness Medicine, 5th Edition, and author of Medicine for the Outdoors, which is the leading book on outdoor health for laypersons. He serves on the National Medical Committee for the National Ski Patrol System and is a recipient of the DAN America Award from the Divers Alert Network, Outstanding Contribution in Education Award from the American College of Emergency Physicians, a NOGI Award in 2006 from the Academy of Underwater Arts and Sciences, Diver of the Year for Science in 2008 from Beneath the Sea, and DAN/Rolex Diver of the Year in 2009. Dr. Auerbach is the world’s leading authority on wilderness medicine. He practices emergency medicine, teaches, performs research, and advises numerous agencies and organizations, including serving as an advisory board member to the AARP Fat 2 Fit Community Challenge. Dr. Auerbach has been hailed as a Hero of Emergency Medicine by the American College of Emergency Physicians.

Extracting Minerals from the Great Salt Lake

Nutritional minerals have been sourced from the Great Salt Lake (GSL) and provided to domestic and international markets since 1969. Endorheic properties of the lake leading to high mineral concentrations, in conjunction with the vastness of the lake, set the GSL apart as the most logical location for nutritional mineral extraction in the world. In spite of the vast abundance of mineral-based resources, only three companies possess water rights with accompanying food-grade mineral extraction claims1; Mineral Resources International, Inc. (MRI), Trace Minerals Research, LLC (TMR), and Salt Lake Minerals Co., LLC (SLM). Significant barriers to entry exist regarding capital requirements, operational liabilities and the acquisition of adequate production technologies. These barriers prevent market entry for actors other than those already established within this market. In addition to external barriers preventing market entry, this market is also characterized by vastly dissimilar business models amongst the sourcing entities. Only MRI implements a traditional solar-evaporation technology when transforming raw GSL water into a concentrated mineral form. The other organizations boast a technology superior to solar-evaporation. Inter-business production method analysis reveals enormous quantitative distinctions regarding concentrated mineral product. In spite of this quantitative distinction, all three entities are successful in marketing product. In-depth analysis suggests that TMR and SLM purchase non-food-grade product from a GSL source and market the product as food-grade in an effort to compete against the industry pioneer MRI. Consumers lack the ability to differentiate between food-grade and nonfood-grade product. Additionally, no mechanism is in place requiring that GSL harvesters selling product marketed as food-grade – actually produce to a level suitable for human consumption.

The rest of the article used to be available on Dr Roberts’ website, however, that seems to be down at the moment, we will update this when we have more info

About Wade C. Roberts, Ph.D.:

Dr. Robert’s received his Ph.D. in economics from the University of Utah in Salt Lake City. In addition to academic training in fields of development, gender, labor, and public economics – he has extensive research experience in Southeast Asia and is fluent in the Cambodian tongue. His is the author of the book titled “The Economics of Ordnance Tampering in Cambodia” – set to be in print by December 2010 with Cambria Press. Dr. Roberts’ has conducted professional research for law firms, governments, non-profits, and various international organizations. Dr. Roberts teaches at both the undergraduate and graduate level at the University of Utah, Westminster College, and Weber State University.

Effects of an Electrolyte Additive on Hydration and Drinking Behavior During Wildfire Suppression

John S. Cuddy, MS; Julie A. Ham, MS; Stephanie G. Harger, MS; Dustin R. Slivka, PhD; Brent C. Ruby, PhD

From the Human Performance Laboratory, University of Montana, Missoula, MT.

Objective.—The purpose of this study was to compare the effects of a water + electrolyte solution versus plain water on changes in drinking behaviors, hydration status, and body temperatures during wildfire suppression.

Methods.—Eight participants consumed plain water, and eight participants consumed water plus an electrolyte additive during 15 hours of wildfire suppression. Participants wore a specially outfitted backpack hydration system equipped with a digital flow meter system affixed inline to measure drinking characteristics (drinking frequency and volume). Body weight and urine-specific gravity were collected pre- and postshift. Ambient, core, and skin temperatures were measured continuously using a wireless system. Work output was monitored using accelerometry.

Results.—There were no differences between groups for body weight, drinking frequency, temper- ature data, activity, or urine-specific gravity (1.019 ± 0.007 to 1.023 ± 0.010 vs. 1.019 ± 0.005 to 1.024 ± 0.009 for water and water + electrolyte groups pre- and postshift, respectively; P < .05). There was a main effect for time for body weight, demonstrating an overall decrease (78.1 ± 13.3 and 77.3 ± 13.3 kg pre- and postshift, respectively; P < .05) across the work shift. The water group consumed more total fluid (main effect for treatment) than the water + electrolyte group (504 ± 472 vs. 285 ± 279 mL·h-1 for the water and water + electrolyte groups, respectively; P < .05). Conclusion.—The addition of an electrolyte mixture to plain water decreased the overall fluid consumption of the water + electrolyte group by 220 mL·h-1 (3.3 L·d-1). Supplementing water with electrolytes can reduce the amount of fluid necessary to consume and transport during extended activity. This can minimize carrying excessive weight, possibly reducing fatigue during extended exercise. Key words: firefighting, ultraendurance, water, electrolyte solution, hydration Introduction In the Northwest United States during the summer months, wildland fire suppression occurs wherever fires threaten human structures, power areas, towns, or cities. The job of the wildland firefighter (WLFF) involves la- borious work during 14-day deployments, composed of 12- to 16-hour days doing activities such as hiking, dig- ging lines, chain sawing, and managing controlled burns.1–3 Wildland firefighters typically work in envi- ronments with high ambient heat (≥40℃), low humid- ity, and rugged terrain. They carry a 12- to 20-kg pack containing food, water, safety gear, and work tools. A considerable amount of weight in the pack (upwards of ~50%) consists of fluids used for personal hydration. To obtain maximal safety and work output, it is critical for the WLFF to eliminate carrying any excessive weight during the workday, which may help reduce fatigue. Using the doubly labeled water methodology, we have previously reported the energy demands of wildfire sup- pression (12–26 MJ · d-1, 2868–6214 kCal · d-1).3 We have also reported rates of water turnover during wild- land fire suppression (6.7 ± 1.4 L·d-1, 94.8 ± 24.1 mL·kg-1·d-1), and WLFFs have been shown to lose approximately 1 kg of body weight following 5 days of work.2 This drop in body weight was accounted for by a decrease of 0.9 kg total body water with minimal changes in urine osmolality and specific gravity. Table 1 descriptive data While wildfire suppression is not a sport, the physiologic stresses mentioned above mirror the metabolic de- mands of ultraendurance athletes. The only difference is the work:rest cycle is about 1:2 for wildfire suppression,1 whereas many ultraendurance sports would be more continuous (ie, Ironman triathlons and ultrarunning). Appropriate fluid balance is critical before, during, and after exercise in order for athletes, as well as WLFFs, to per- form optimally.4–7 Hydration during exercise events is important not only to maximize performance, but to avoid deleterious health problems, such as heat exhaustion, hyponatremia, acute renal failure, or rhabdomyolysis.7–9 Maintaining euhydration is important for athletes and WLFFs, but fluid balance can be maintained even when individuals lose weight. When athletes exhibit weight loss during extended exercise but remain in fluid balance, it has been suggested that the weight loss is a consequence of fat and glycogen loss, as well as the intracellular water stored with glycogen.2,10,11 Considerable research has investigated the effects of sodium and/or other electrolytes added to drinks to improve hydration status during exercise and to restore hydration more quickly following an exercise bout.12,13 There is evidence during ad-libitum fluid intake situa- tions that flavored drinks are more efficacious for fluid balance than plain water.14–16 During extended exercise, sodium supplementation has been shown to decrease weight loss compared to placebo17 and reduce dehydra- tion.18 However, there appears to be no performance benefit to sodium supplementation during extended exercise.17,19,20 During rehydration, consumption of fluids containing electrolytes typically decreases urine out- put,21–23 better restoring fluid balance postexercise. However, Mitchell et al24 showed no differences in urine volume when large quantities of fluid were consumed with or without sodium. Although past research on WLFFs has clearly indi- cated a demanding work environment that challenges en- ergy balance and hydration status, data regarding drinking patterns and its effect on hydration status and thermoregulatory stress have not been collected. This has been limited by a lack of available technology that allows unhindered work efforts by the participants and comfortable equipment to monitor these parameters under field conditions. The purpose of this study was to compare the effects of a water + electrolyte solution versus plain water on changes in drinking behaviors, hydration status, and body temperatures during wildfire suppression. It was hypothesized that there would be minimal differences between those consuming the water + electrolyte solution versus water due to the small amounts of electrolytes added. Methods PARTICIPANTS Participants included male (n = 12) and female (n = 4) type II professional WLFFs working at a fire in the Northwestern United States (for descriptive data, see Table 1). Upon arrival at the incident, participants were recruited during an informational meeting. Four participants completed the study each day; 2 participants received water and two received water + electrolyte in a double-blind fashion. All WLFFs wore standard fire equipment: Nomex long-sleeve shirt and pants, midcalf leather logger boots, a 100% cotton short-sleeve under- shirt, leather gloves, hard hat, and a 12- to 20-kg pack containing food, water, safety gear, and work tools.3 The study was approved by the University of Montana In- stitutional Review Board, and participants provided written consent prior to data collection. EXPERIMENTAL DESIGN Participants were randomly placed in one of 2 groups: water (consumption of water only) and water + electrolyte (consumption of water with electrolyte additive). The electrolyte additive consisted of a commercially available product (Elete by Mineral Resources, Ogden, UT). Each L of water + electrolyte contained 22.8 mmol·L-1 of electrolytes (45 mg magnesium, 125 mg sodium, 390 mg chloride, 130 mg potassium, and 20 mg sulfate). Table 1 descriptive data Following the collection of morning nude body weight and first void urine sample, participants ingested a core temperature capsule (Jonah capsule, Mini Mitter a Respironics Company, Bend, OR) and had a skin tem- perature sensor (Mini Mitter) placed on the lateral side of the left deltoid. This skin site was selected to avoid irritation with the line gear and radio packs worn during the work shift. An additional surface temperature sensor was placed on the outside of the VitalSense monitor holster (Mini Mitter), which was worn on the firefigher’s belt. Participants were then allowed to consume the standard catered breakfast provided, which consisted of unlimited portions of food and drink. After breakfast, participants were provided with a specially outfitted backpack hydration system (3-L capacity CamelBak, Petaluma, CA). Each system was equipped with a digital flow-meter system affixed inline to allow for the measurement of drinking characteristics (drinking frequency and drinking volume). This system has been validated for accuracy and reliability.25 Activity data were collected using the ActiCal actig- raphy units (Mini Mitter) via methods previously described.1 Briefly, activity monitors were initialized to collect data at the beginning of the shift, placed on a white foam square (~7.6 cm ~ 7.6 cm), and inserted in the left shirt pocket of participants. These monitors de- tect movement in an omnidirectional fashion, ideal for sensing upper body movements frequently performed by WLFFs. Upon deployment, participants were instructed to work their entire shift while consuming all fluid through the drinking system. Participants were instructed to drink as much or as little fluid as they desired during the work shift. Solid food consumption was ad libitum, consisting of a sack lunch containing ~6.3 to 8.4 MJ (~1506 to 2008 kCal) if completely consumed, and other supple- mentary foods, such as miscellaneous food bars and sea- soned dried meat.1 While in the field, participants refilled their drinking system as needed by pouring 3 L of water into the Camelback and adding a small vial of either placebo or electrolyte mix. The refilling procedure should not have unblinded participants to the drink, unless they tasted the contents of the vial before pouring it into the Camelback. After the completion of the work shift, nude body weight was measured and urine samples were evaluated for specific gravity using a hand held refractometer (Ata- go Uricon-NE, Farmingdale, NY) calibrated to distilled water. At this time, skin sensors were removed and the VitalSense data logger, digital drinking system, and activity monitors were downloaded. STATISTICAL ANALYSIS Data were analyzed using a mixed-design analysis of variance (trial x time) with repeated measures to evaluate changes across the work shift and between the water and water + electrolyte groups. Statistical significance was established using an ∝ level of P < .05. Results BODY WEIGHT There was a main effect for time for the overall decrease in nude body weight across the work shift (P < .05) (Table 2). There was no statistically significant difference between the water and water + electrolyte groups. DRINKING BEHAVIOR The water group consumed more total fluid throughout the whole day than the water + electrolyte group (504 ± 472 vs. 285 ± 279 mL·h-1 for the water and water + electrolyte groups, respectively; P < .05). Drinking volume was higher (main effect for time) during hours 6 to 13 compared to hour 2; P < .05 (Figure 1). Drink- ing data for the first hour were not analyzed, since during this hour crews were in camp and did not consume fluid from the hydration system. There was no difference between groups for number of drinks throughout the day (93 ± 28 and 99 ± 32 drinks·d-1 for the water and water + electrolyte groups, respectively; Figure 2). There was a main effect for time indicating more drinks · h-1 during hours 8 to 13 than during hour 2. TEMPERATURE There were no significant differences in ambient, core, or skin temperature between the water and the water + electrolyte group (Figure 3). Ambient temperature was significantly (P < .05) elevated from hours 4 to 15 compared to hour 1. Core body temperature was significantly (P < .05) elevated from hours 2 to 15 compared to hour 1. Skin temperature was significantly (P < .05) elevated from hours 3 to 15 compared to hour 1. Table 1 descriptive data ACTIVITY There was no difference between the water and water + electrolyte groups in average self-selected work output over the entire workday (426 ± 328 and 483 ± 311 counts·min-1·h-1, for the water and water + electrolyte groups, respectively; Figure 4). There was a significant main effect for time, with work output during hours 5 to 9 and 11 higher compared to hour 1. URINE-SPECIFIC GRAVITY There was a significant increase in urine-specific gravity from preshift to postshift (P < .05) (Table 2). However, there was no difference between the water and water + electrolyte groups. Discussion The primary finding from the current study is that when an electrolyte supplement was added to plain water, individuals consumed significantly less fluid overall (220 mL·h-1, or 3.3 L·d-1) during 15 hours of wildland fire suppression yet exhibited similar thermoregulatory stress responses and body weight change. Participants in both groups sustained similar decrements in body weight (-0.5% ± 0.9 and -1.4% 1.3 for the water and water + electrolyte groups, respectively) and changes in urine- specific gravity despite the water + electrolyte group consuming 43% less fluid (7.6 ± 2.4 vs. 4.3 ± 1.8 L·d-1 for the water and water + electrolyte groups, re- spectively) over the 15-hour work shift. Reducing the need for fluid by 43% demonstrated in the water + electrolyte group would allow time to be more effectively spent in direct wildfire suppression activities. However, there were no differences in self-selected work output patterns between the groups. Without any fluid intake suggestions, recommendations, or guidelines, WLFFs in both groups were able to self-select a sufficient amount of fluid to maintain similar levels of hydration while engaged in difficult working conditions. Table 1 descriptive data The hourly drinking volume for the water group (504 ± 472 mL·h-1) is similar compared to reported literature,4,7,11,26 while the water + electrolyte group con- sumed less (285 ± 279 mL·h-1) than typically reported. Even though the intensity at which WLFFs work is con- siderably less than ultraendurance exercise events,1 the work shift duration is similar to or longer than such sporting events. During wildland fire suppression efforts in the Australian bush, Hendrie et al26 showed that fire- fighters consumed 331 mL·h-1, dehydrating at a rate of 0.9% body mass per hour, even when water and time to drink it was readily available. Participants in the Hendrie study consistently drank too little, demonstrating a pattern called ‘‘voluntary dehydration,’’ first recognized by Adolph in 1947 while researching soldiers in the desert.27 Typical fluid intakes for ultraendurance exercise have been reported between ~300 to 1300 mL·h-1 (4), with intakes during Ironman triathlons reported at 716 mL·h-1, (11) and 1.5 L·h-1.28 For WLFFs, military combatants, mountain climbers, backpackers, and others for whom water sources may be scarce, the current data suggest that adding additional electrolytes to fluid mixtures might reduce the amount of fluids that need to be consumed, thus reducing the amount that might have to be transported subsequently reducing load carriage and the energy demands associated with load carriage. Future research should explore whether using supplemental electrolytes over a longer duration study (~14 days) would reduce the amount of fluid necessary to maintain hydration. In the current study, environmental conditions during the work shift followed typical trends for the Northwest United States during the month of August: hot and dry, with low humidity. Temperatures hovered between 29°C and 38°C during hours 6 to 13 of the work shift, and it was common for some participants to experience ambi- ent temperatures exceeding 40°C, with 1 subject expe- riencing 1 average hourly ambient temperature of 46.8°C. Participants consumed a significantly higher vol- ume of fluid during hours 6 to 13, paralleling the increase in ambient temperatures and activity (Figures 1, 3, and 4). During hours 6 to 13 (mean ambient temperature 34.4 ± 4.6°C), participants consumed a mean volume of 568 ± 422 mL·h-1, consistent with reported voluntary fluid intakes during various sports.7 Additionally, participants took more frequent drinks as the work shift progressed and temperature increased, particularly during hours 6 to 13 (Figure 2). The increases in drinking volume and frequency parallel the increases in am- bient temperature and activity, suggesting that increasingly stressful environmental conditions coupled with consistent work activity increase the need/desire for increased fluid intake (Figures 2, 3, and 4). Despite the large difference in overall drinking vol- ume between groups, WLFFs in the current study dem- onstrated similar drinking frequency patterns. Partici- pants drank a comparable number of times during the day, 93 ± 28 and 99 ± 32 for the water and water + electrolyte groups, respectively. Speedy et al17 suggested that sodium ingestion during exercise could have an effect on thirst, causing athletes to consume more fluid during an Ironman race compared to athletes not supplementing with sodium. Other studies where ad libitum drinking was permitted have shown flavored drinks enhance fluid balance14–16; however, in studies where fluid intake was provided to match sweat rate, there was no benefit to consuming drinks with saline or carbohydrate + electrolyte.29,30 It has been previously demonstrated that sodium supplementation reduces urine output and expands plasma volume, thus hastening rehydration.21,23 The water + electrolyte group may have had a reduced urine production due to the addition of electrolytes to their drink, thus minimizing the need to consume more fluid, while the water group drank more but had a higher urine production. This is a definite possibility in the current study, since it has been suggested sodium intake activates hormonal control mechanisms and reduces the excretion of water.23 Urine output data were not collected, so this is speculation. However, slight changes in urine production during the day, especially a 15-hour work shift, would accumulate over a long duration. It is difficult to accurately ascertain the hydration sta- tus of WLFFs in the current study, since study participants were several days into their 14-day deployment, and no baseline data were collected prior to its beginning. Nonetheless, the primary 2 markers we collected to monitor hydration, body weight and specific gravity, indicated no difference between groups. The weight loss was slightly greater (though not significant) for the water + electrolyte group, both as an absolute and a percentage of body weight. For both groups, the mean decrease in weight from pre to postshift was 1.0 ± 1.2% of body weight, while specific gravity increased from 1.019 ± 0.005 g·mL-1 to 1.023 ± 0.009 g·mL-1 from pre- to postshift. The small weight loss the WLFFs experienced was within the accepted euhydration cut-off (<2%) as outlined by the recent position stand by the American College of Sports Medicine.7 However, the post measure of specific gravity was slightly greater than the euhydration cut-off (<1.020 g·mL-1) recommended in the same position stand. Technically, these 2 variables would suggest our participants began the day euhydrated and finished the day slightly dehydrated. However, prior to the beginning of the work shift the urine-specific gravity was close (0.001 g·mL-1) to the euhydration cut-off point and then changed minimally (0.004 g·mL-1) during 15 hours of wildland fire suppression. It is possible that WLFFs consistently fluctuate between the point of euhydration and dehydration during the day. Given the high energy expenditure3 and rates of water turnover2 during wildland fire suppression, the self-selected fluid intake created minimal disturbance in the hydration status of the current participants (ie, weight loss was minimal and urine-specific gravity changed little). Whether the slight weight loss observed during this study came from sweat or substrate utilization, as has been previ- ously suggested,2 remains unknown. Accurately calculating sweat rate in this environment would have been a formidable task, and because of individual variability in sweat rates, a general assumption cannot be made. Further research may be warranted to evaluate substrate utilization or glycogen loss during wildland fire suppression. Some WLFFs commented the water + electrolyte was less desirable than plain water, even though the amount of electrolytes in the water + electrolyte drink was 22.8 mmol·L-1, considerably below the levels that might de- crease palatability, as suggested by Barr et al.29 Barr et al29 have suggested that high levels of electrolytes (43– 87 mmol·L-1) added to water would decrease the palatability of drinks, while Speedy17 has suggested that increased sodium in water would increase the desire to drink (thus athletes would consume more water). Even if there was a decrease in the palatability of the water + electrolyte drink resulting in reduced intake compared to water, both groups maintained similar decrements in body weight and increases in urine-specific gravity. In addition, there were no differences in core or skin temperatures, suggesting similar thermoregulatory stress responses. While all attempts were made to control extraneous factors that might influence results in this study, there are several limitations. First, the palatability of the electrolyte solution could have discouraged subjects from consuming copious amounts of fluid, but many participants remarked their drinks tasted normal. However, there was no effort to equalize taste between the water and water + electrolyte drinks, and no formal attempt was made to assess the palatability of the electrolyte mix. Oftentimes CamelBak packs incur a ‘‘plastic’’ taste to water, and perhaps this masked any taste differences of the electrolyte solution. Next, there is the possibility that WLFFs consumed water from other sources throughout the day. They had access to plain water and possibly sports drinks, but were instructed to only drink from their Camelback. From many years of research with the WLFFs, our laboratory has found them to be cooperative, diligent, and honest with their efforts. Further, it is possible that urine-specific gravity and body weight measures were too crude to detect hydration changes, or normal physiologic hydration reserves and compensatory mechanisms minimized any differences. Finally, researchers collected no dietary information regarding the frequency or amount of snacks and foods consumed during the work shift. Food intake could have impacted body weight changes, especially if subjects in the electrolyte group chose to eat more. If that were the case, differences in body weight resulting from dissimilar drinking patterns would have been minimized. However, participants were provided similar sack lunches to consume during the day, so food intake was most likely consistent between groups. In summary, the addition of an electrolyte mixture to plain water was associated with a decrease in overall fluid consumption of the water + electrolyte group by 220 mL · h-1, or 3.3 L · d-1. Participants exhibited minimal changes in hydration status during 15 hours of arduous work by adequately self-selecting fluid intake under demanding environmental and work conditions. Having to transport and consume less fluid during the extended physical activity can minimize carrying excessive weight, possibly reducing fatigue during extended exercise. Acknowledgments This research was funded by the United States Forest Service (USFS) and Mineral Resources (manufacturers of Elete). References Cuddy JS, Gaskill SE, Sharkey BJ, Harger S, Ruby BC. Supplemental feedings increase self-selected work output during wildfire suppression. Med Sci Sports Exerc. 2007; 39:1004 –1012. Ruby BC, Schoeller DA, Sharkey BJ, Burks C, Tysk S. Water turnover and changes in body composition during arduous wildfire suppression. Med Sci Sports Exerc. 2003; 35:1760 –1765. Ruby BC, Shriver TC, Zderic TW, Sharkey BJ, Burks C, Tysk S. Total energy expenditure during arduous wildfire suppression. 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Oral salt supplementation during ul- tradistance exercise. Clin J Sport Med. 2002;12:279–284. Sanders B, Noakes TD, Dennis SC. Sodium replacement and fluid shifts during prolonged exercise in humans. Eur J Appl Physiol. 2001;84:419–425. Hew-Butler TD, Sharwood K, Collins M, Speedy D, Noakes T. Sodium supplementation is not required to maintain serum sodium concentrations during an ironman triathlon. Br J Sports Med. 2006;40:255–259. Twerenbold R, Knechtle B, Kakebeeke TH, et al. Effects of different sodium concentrations in replacement fluids during prolonged exercise in women. Br J Sports Med. 2003;37:300 –303. Costill DL, Sparks KE. Rapid fluid replacement following thermal dehydration. J Appl Physiol. 1973;34:299 –303. Maughan RJ, Owen JH, Shirreffs SM, Leiper JB. Post- exercise rehydration in man: Effects of electrolyte addition to ingested fluids. Eur J Appl Physiol Occup Physiol. 1994;69:209 –215 Nielsen B, Sjogaard G, Ugelvig J, Knudsen B, Dohlmann B. Fluid balance in exercise dehydration and rehydration with different glucose-electrolyte drinks. Eur J Appl Phy- siol Occup Physiol. 1986;55:318–325. Mitchell JB, Phillips MD, Mercer SP, Baylies HL, Pizza FX. Postexercise rehydration: Effect of Na(+) and volume on restoration of fluid spaces and cardiovascular function. J Appl Physiol. 2000;89:1302–1309. DeGroot DW, Kesick CM, Stulz RW, Hoyt RW, Lanza JF, Montain SJ. New instrument to measure ad libitum fluid intake in the field [abstract]. Med Sci Sports Exerc. 2001; 33:S257. Hendrie A, Brotherhood J, Budd G, et al. Project aquarius 8: Sweating, drinking, and dehydration in men suppressing wildland fires. Int J Wildland Fire. 1997;7:145–158. Adolph E. Physiology of Man in the Desert. New York, NY: Interscience; 1947. Applegate EA, O’Toole ML, Hiller WDB. Race day die- tary intakes during an ultraendurance triathlon [abstract]. Med Sci Sports Exerc. 1989;21:S48. Barr SI, Costill DL, Fink WJ. Fluid replacement during prolonged exercise: Effects of water, saline, or no fluid. Med Sci Sports Exerc. 1991;23:811–817. Byrne C, Lim CL, Chew SA, Ming ET. Water versus car- bohydrate-electrolyte fluid replacement during loaded marching under heat stress. Mil Med. 2005;170:715–721

Trace Minerals and pH: It’s Simply a Matter of Health

By Chris D. Meletis, N.D.

Understanding the role of pH in human health and how minerals can help.

The human body contains a massive amount of ongoing chemical reactions. The majority of these processes occur within our cells—the smallest building blocks of our bodies. Like a factory, the body produces wastes that can be quite toxic to the body if not disposed of properly. A large percentage of waste produced by our cells finds its way into the bloodstream. These wastes can alter the environment of the blood in a negative way if they are not rapidly metabolized. One of the major cellular waste products is hydrogen ions. These ions are responsible for changing the environment of the blood, mainly by making the blood more or less acidic, which can be very detrimental to the functioning of other bodily processes.

In the science of chemistry, the degrees of acidity or alkalinity of a substance are expressed in pH values. The pH system, or potential of hydrogen, is measured on a scale from 0 to 14. The point at which a substance is neither acidic nor alkaline is measured at point 7. Increasing acidity is displayed as any number less than 7, while increasing alkalinity is expressed as any number above 7. Thus, maximum acidity is measured at 0, while maximum alkalinity is measured at 14. Additionally, each unit on the scale is logarithmically derived, meaning that there is a factor of ten between each digit. So,a pH of 2 is ten times more acidic than a pH of 3,and a pH of 1is100 times more acidic than a pH of 3.

The pH of blood is closely maintained between 7.45 and 7.35. More specifically, the blood within the arterial system stays near 7.45, while the blood within the veins stays near 7.35. Venous blood is more acidic due to the large amounts of hydrogen ions indirectly produced from carbon dioxide released from the tissues. It is noteworthy to point out that the chemically neutral mark for blood is a pH of 7.4, which is slightly more alkaline than the standard neutral point of 7.0. Death may rapidly occur if the blood pH falls outside the range of 6.8 to 8.0 for more than a few seconds, as a blood pH outside of this range is incompatible with life. This fact greatly relays the importance of careful regulation of hydrogen ion concentration in the body.

Regulation of pH is also referred to as acid-base balance. The body is constantly working to maintain a balance between too many acid products and too many alkaline, or basic products. Normally, the body is able to maintain an acid-base balance with little difficulty. The lungs and the kidneys are the

primary organs by which the body regulates its supply of acids and bases. It is when we do not have enough raw materials for the body to accomplish its task that we run into problems with acid-base balance.

Even small changes in acid-base balance can have dramatic effects on the normal function of cells within our bodies. For instance, one of the main manifestations of acidosis is a depressive effect on the central nervous system. This may be experienced as disorientation and, in more severe episodes, as coma. Conversely, a person who tends to have more alkaline blood will experience overexciteability of the nervous system, such as nervousness, tingling, spasms, and twitches of the muscles. Excessive alkalinity that is not promptly addressed can lead to violent muscle spasms and convulsions.

Even small changes in acid-base balance can have dramatic effects on the normal function of cells within our bodies.
The most important nutrients in our bodies for maintaining acid-base balance are certain minerals. More specifically, sodium, potassium, chloride, and bicarbonate (a combination of hydrogen, carbon, and oxygen molecules) are responsible for the precise balance involved. Physicians routinely analyze the proportions of these elements in order to determine one’s relative acid-base concentrations. By fine-tuning the relative amounts of these elements in the blood, many practitioners of natural medicine can work to improve their patient’s overall balance with the environment. The amounts of sodium, potassium, chloride and bicarbonate can be mathematically compared to arrive at a general consensus in regard to how well the body is dealing with its production of hydrogen, a waste product.

As stated earlier, a buildup of hydrogen can lead to imbalances in the acid-base ratio. If the physician finds an unusual ratio between those different elements, he/she may suspect an irregularity in the production and clearance of hydrogen in the patient. Natural medicine practitioners will then design and implement a treatment geared toward correcting this imbalance, by intervening with strategic use of absorbable minerals and trace minerals to reestablish a healthful balance.

Summary

Analyzing acid-base balance and the concentrations of minerals in the blood provides yet another way for the practitioner of natural medicine to address the ability of the body to maintain homeostasis, or balance. By supplying the body with enough of the smaller, lesser-known substances found in nature, physicians can steer how the body reacts to its own internal production of wastes and to external influences on its health. Additionally, by preventing excessive fluctuations in acid-base balance, the body may be more apt to heal itself from chronic forms of illness. Thus, in summary, maintaining the complex functioning of the body’s tightly regulated pH system requires maintaining proper mineral and trace mineral levels to sustain optimal and healthful balance.

References:

Sherwood. L. Human Physiology From Cells to Systems, 3rd Edition. 1997.
J Hooper, WJ Marshall, AL Miller. Log-jam in acid-base education and investigation: why make it so difficult? Annals of Clinical Biochemistry 1998 35: 85-93.
Schlichtig R, Grogono AW, Severinghaus JW: Current status of acid-base quantitation in Physiology and Medicine. Anesthesiology Clinics of North America, March.16: 211-233. 1998.
Schlichtig R, Grogono AW, Severinghaus JW: Human PaCO2 and Standard Base Excess Compensation for Acid-Base Imbalance. Critical Care Medicine. 26:1173-1179. 1998.
Grogono AW, Byles PH, Hawke W: An in-vivo representation of acid-base balance. Lancet, ii: 499, 1976.

Magnesium, Health, and Disease Prevention

By Chris D. Meletis, N.D.

Magnesium is one of the major mineral nutrients in the human body. Containing approximately 20 to 28 grams of magnesium, 60 percent is found in the bones and teeth, while the remaining 40 percent is found in muscle. Serum levels of magnesium range from 1.5 to 2.1 mEq/L; magnesium is the second-most plentiful positively charged ion found within the cells of the body, signifying its importance in the multitudes of physiologic cellular functions. One of the most important metabolic processes, the synthesis and consumption of ATP is directly linked to magnesium. Magnesium-linked ATP processes activate approximately 300 different enzymes which are involved in diverse functions such as DNA and RNA synthesis, glycolysis, intracellular mineral transport, nerve impulse generation, cell membrane electrical potential, muscle contraction, blood vessel tone, and the regeneration of ATP.1

The adult Recommended Dietary Allowance (RDA) for magnesium is 350 mg per day for men and 280 milligrams for women. The typical American diet provides approximately 120 milligrams per 1,000 calories, meaning that a person that consumes fewer than 1,500 calories is likely to be deficient in magnesium. The absorption rate of magnesium ranges from 24 to nearly 85 percent, while magnesium derived from metallic sources is less absorbable, whereas magnesium derived from plant sources is more easily absorbed. Factors that increase the need for magnesium due to limited uptake or increased losses include excess phosphate consumption (soft drinks) and alcoholic beverages, high-stress lifestyles, some diuretics, digitalis, strenuous exercise (high-performance athletes lose a considerable amount of magnesium in sweat), pregnant and lactating women, individuals with diabetes, severe diarrhea, or kidney disease. The early signs of magnesium deficiency include vague symptoms such as loss of appetite, stomachache, and diarrhea. Longer-term deficiency symptoms may manifest as confusion, apathy, depression, irritability, arrhythmia, weakness, poor coordination, nausea, vomiting, electromyographic changes, muscle and nerve irritability, and tremors.2

Magnesium has many novel uses for common health conditions. As an antacid, magnesium salts react with gastric acid to form magnesium chloride, thereby neutralizing hydrochloric acid. As a laxative, magnesium acts osmotically in the intestine and colon as well as triggering the release of gastrin and cholecystokinin, stimulating gastric motility. The inhibitory effect of magnesium on pre-term labor contractions (tocolysis) is attributed to antagonism of calcium- mediated uterine contractions, while the anticonvulsant actions of magnesium in eclampsia may be due to inhibition of neuromuscular transmission, and a resulting depressant effect on smooth muscle contraction.3

Magnesium and Blood Pressure

Magnesium has an important role in reducing blood pressure.4 Magnesium deficiency has been found to allow for increased intracellular concentrations of sodium and potassium, which results in increased peripheral resistance and vasospasm.5 Additionally, some research points out that hypertensive patients with hypomagnesemia usually require more antihypertensive medications than hypertensive patients with normal magnesium levels.6 Diets that contain plenty of fruits and vegetables, which are good sources of potassium and magnesium, are consistentlyassociatedwithlowerbloodpressure.7 Theeffectofvariousnutritionalfactorson incidence of high blood pressure was examined in over 30,000 U.S. male health professionals. After four years of follow-up, it was found that a greater magnesium intake was significantly associated with a lower risk of hypertension.8 The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends maintaining an adequate magnesium intake as a positive lifestyle modification for preventing and managing high blood pressure.9

The typical American diet provides approximately 120 milligrams per 1,000 calories, meaning that a person that consumes fewer than 1,500 calories is likely to be deficient in magnesium.
Magnesium and Heart Disease

Magnesium may play a role in reducing coronary vascular resistance, increasing coronary artery blood flow parameters, and prevention of arrhythmia. Further, inadequate intake and absorption of magnesium are associated with the development of disease processes such as hypertension, cardiomyopathy, atherosclerosis, and stroke.10 Evidence exists that indicates low body stores of magnesium actually increase the risk of a person having arrhythmia, which can increase the risk of cardiovascular complications.11 Surveys of the population in general have associated higher blood levels of magnesium with lower risk of coronary heart disease.12 Additionally, dietary surveys have suggested that a higher magnesium intake is associated with a lower risk of stroke.13

Magnesium and Osteoporosis

Magnesium deficiency may be a risk factor for postmenopausal osteoporosis. This may be related to the fact that magnesium deficiency negatively alters calcium metabolism and the hormone that regulates bone-calcium stores.14 Several studies have suggested that magnesium supplementation may improve bone mineral density, and low intake and impaired absorption of magnesium have also been associated with the development of osteoporosis.

Magnesium and Diabetes

Magnesium plays an important role in carbohydrate metabolism, influencing the release and activity of insulin, the main hormone that exerts control of blood glucose levels. Elevated blood glucose levels can increase the loss of magnesium in the urine, leading to increased magnesium loss from the body. Commonly, low serum levels of magnesium are often seen in poorly controlled diabetics.

Magnesium and Asthma

Magnesium plays a dynamic role in lung structure and function. Magnesium acts to block the function of calcium, which, in the lungs, causes bronchial smooth-muscle contraction. The possibility exists that magnesium deficiency may contribute to lung complications. It is interesting to note that the average calcium consumption in the U.S. has increased in the past few years, but this is accompanied by little change in magnesium intake, causing an imbalance in the calcium: magnesium ratio.15 This deficiency in magnesium also has an effect on the activity of specific white blood cells (neutrophils) that, during an asthma attack, can worsen the condition. Researchers theorize that low magnesium content of white blood cells has an important effect on the pathogenesis of asthma.16 It is additionally hypothesized that a diet high in magnesium is directly related to healthy lung function and a reduced risk of airway hyper reactivity and wheezing. Low magnesium intake may therefore be involved in the occurrence of asthma.17

The beneficial health effects of magnesium and its disease-prevention qualities emphasize the importance of this commonly overlooked mineral. As the fields of nutrition and medicine continue to reveal the benefits of magnesium, it becomes more and more apparent that supplementation with this mineral is vital to maintaining our health. Like all supplements, proper supplementation of magnesium must be emphasized by seeking the advice of a qualified, nutritionally-oriented physician.

References:

Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.

Whitney E, Cataldo CB, Rolfes SR, eds. Understanding Normal and Clinical Nutrition. Belmont, CA: Wadsworth, 1998.

Swain R, Kaplan-Machlis B. Magnesium for the next millennium. South Med J 1999; 92: 1040-7.

Yamori Y, Nara Y, Mizushima S, et al. Nutritional factors for stroke and major cardiovascular diseases: international epidemiological comparison of dietary prevention. Health Rep 1994; 6(1): 22-7.

Douban S, Brodsky MA, Whang DD, Whang R. Significance of magnesium in congestive heart failure. Am Heart J 1996; 132(3): 664-71.

Altura BT, Memon ZI, Zhang A, et al. Low levels of serum ionized magnesium are found in patients early after stroke which result in rapid elevation in cytosolic free calcium and spasm in cerebral vascular muscle cells. Neurosci Lett 1997;230:37-40.

Simopoulos AP. The nutritional aspects of hypertension. Compr Ther 1999;25:95-100.

Ascherio A, Rimm EB, Giovannucci EL, Colditz GA, Rosner B, Willett WC, Sacks FM, Stampfer MJ. A prospective study of nutritional factors and hypertension among US men. Circulation 1992;86:1475-84.

National Heart, Lung, and Blood Institute. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997;157:2413-46.

Appel LJ. Nonpharmacologic therapies that reduce blood pressure: A fresh perspective. Clin Cardiol 1999;22:1111-5.

Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999.

Ford ES. Serum magnesium and ischaemic heart disease: Findings from a national sample of US adults. Intl J of Epidem 1999;28:645-651.

Ascherio A, Rimm EB, Hernan MA, Giovannucci EL, Kawachi I, Stampfer MJ, Willett WC. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 1998;98:1198-204.

Rude RK and Olerich M. Magnesium deficiency: Possible role in osteoporosis associated with gluten-sensitive enteropathy. Osteoporos Int 1996;6:453-61.

Landon RA, Young EA. Role of magnesium in regulation of lung function. J Am Diet Assoc 1993 Jun;93(6):674-7.

Fantidis P, Ruiz Cacho J, Marin M, Madero Jarabo R, Solera J, Herrero E. Intracellular (polymorphonuclear) magnesium content in patients with bronchial asthma between attacks. J R Soc Med 1995 Aug;88(8):441-5.

Britton J, Pavord I, Richards K, Wisniewski A, Knox A, Lewis S, Tattersfield A, Weiss S. Dietary magnesium, lung function, wheezing, and airway hyperreactivity in a random adult population sample. Lancet 1994 Aug 6; 344(8919): 357-62.

Electrolyte Additives for Hydration

By Paul S. Auerbach, MD, MS, FACEP, FAWM

The current issue of the journal Wilderness & Environmental Medicine, published by the Wilderness Medical Society, has a number of very interesting articles of significance to the layperson outdoor medicine enthusiast.

“Effects of an Electrolyte Additive on Hydration and Drinking Behavior During Wildfire Suppression,” by John S. Cuddy and his colleagues (WEM volume 19, pages 172-180, 2008), describes a study designed to compare the effects of a water plus electrolyte solution versus plain water on changes in drinking behaviors, hydration status, and body temperatures during wildfire suppression activities. In this particular study, eight participants consumed plain water, and eight participants consumed water plus an electrolyte additive (Elete by Mineral Resources, Ogden, Utah) that contained magnesium, sodium, chloride, potassium and sulfate. The participants were provided specially outfitted backpack hydration systems with three-liter capacity from CamelBak (Petaluma, California).

During the measurement period, the participants were monitored for volume of fluid consumed, body weight, core, and skin temperatures. Work output was measured, as was the environmental temperature. The results indicated that all things being equal, the major difference noted between the water group and the water plus electrolytes group was that a remarkably lower fluid consumption (approximately 3.3 liters per day) was noted in the water plus electrolytes group. This suggests that supplementing water with electrolytes might reduce the amount of fluid necessary to transport and consume during extended activity. This would minimize excessive weight, which in and of itself might contribute to a lessening of fatigue.

In this study, the amount of fluid consumed was at the discretion of the participant, so was presumably driven by thirst. It would be very interesting to replicate this study in other situations where rehydration is important, such as high altitude travel, competitive sports, and recreational sports. It would be important to control for as many variables as possible, such as beverage temperature, taste, food intake, and so forth. It would also be useful to determine if this information has any applicability in a survival situation.

Health Matters – Health Expert Biography

Paul S. Auerbach, MD, MS, FACEP, FAWM

Professor of Surgery in the Division of Emergency Medicine at Stanford University Medical Cent Officer and Chair of the Medical Advisory Board for Healthline; A Founder of the Wilderness M Fellow, American College of Emergency Physicians; Fellow, Academy of Wilderness Medicine

Medical Specialty: Emergency Medicine
Healthline Blog: Medicine for the Outdoors

Dr. Paul S. Auerbach is Professor of Surgery in the Division of Emergency Medicine at Stanford University School of Medicine. Dr. Auerbach is a founder and past president of the Wilderness Medical Society, editor of the definitive medical reference text Wilderness Medicine, 5th Edition, and author of Medicine for the Outdoors, which is the leading book on outdoor health for laypersons. He serves on the National Medical Committee for the National Ski Patrol System and is a recipient of the DAN America Award from the Divers Alert Network, Outstanding Contribution in Education Award from the American College of Emergency Physicians, a NOGI Award in 2006 from the Academy of Underwater Arts and Sciences, Diver of the Year for Science in 2008 from Beneath the Sea, and DAN/Rolex Diver of the Year in 2009. Dr. Auerbach is the world’s leading authority on wilderness medicine. He practices emergency medicine, teaches, performs research, and advises numerous agencies and organizations, including serving as an advisory board member to the AARP Fat 2 Fit Community Challenge. Dr. Auerbach has been hailed as a Hero of Emergency Medicine by the American College of Emergency Physicians.

Clinical Study which demonstrates that elete can reduce the amount of water needed to hydrate by more than 40%

This is a significant benefit when considering how heavy water is to carry and was revealed in a peer review published study using forest fire fighters in California. The study was conducted in the summer of 2008 by The University of Montana, in which 8 forest fire fighters were given water with elete added and 8 were given plain water over a period of five days of intense forest fire fighting. The results were astounding; those with elete in their water on average consumed 42.6% less fluid.

The following documents comprise a peer review of the study, a summary abstract of the study, and the full text of the study titled:
Fire Fighter Hydration Clinical Study – Peer Review by Paul S Auerbach, M.D. of Stanford University – January 2009 Fire Fighter Hydration Clinical Study – Full Report
Effects of an Electrolyte Additive on Hydration and Drinking Behavior During Wildfire Suppression.

Muscle Cramps and Spasms: The Electrolyte Misconnection

Muscles need sufficient electrolytes–sodium, magnesium, potassium and chloride—in proper balance to function properly. The body manipulates the balance of these minerals inside and outside of muscle cells in order to get the muscles to contract and relax. An imbalance or deficiency of these electrolytes can cause problems with the body’s electrical impulses and lead to muscle cramps and/or muscle spasms. Low levels of any of these minerals can allow the muscle to contract, but prevent it from relaxing.

Electrolyte imbalances can occur due to deficiencies in the diet, sweat, urination, diarrhea, medication side effects, from consuming diuretics, and from problems with absorption. Electrolyte deficiencies can also be caused by increased demand for minerals in the body such as in the case of pregnancy or healing. Muscle cramps often occur in middle-aged and older people and are common in athletes. Some researchers believe a mineral imbalance can negatively affect blood flow to the muscles and that a deficiency of some minerals, like potassium, can interfere with the muscles’ ability to use glycogen, a sugar that is the muscles’ main source of energy.

Long-distance runners and cyclists, even individuals who exercise regularly, are prone to cramps. Often, these individuals have electrolyte deficiencies or imbalances because they lose critical electrolytes in sweat. Other factors associated with muscle cramps include dehydration, inactivity, or remaining in a particular position—for example on a bicycle—for long periods of time; anatomical conditions, such as flat feet; physical conditions, such as pregnancy; or the use of certain drugs, i.e., diuretics.

So what can you do to ward off painful muscle cramps or provide relief should one happen to strike?

First, consider adding essential electrolytes, i.e., sodium, magnesium, potassium before cramping occurs, etc. Sodium is one the primary electrolytes lost through sweat and is a nutritional concern if your intake is low, if you sweat heavily during exercise, or if you exercise for long periods of time. Besides sodium, other important electrolytes are magnesium, potassium, and chloride. Magnesium, for instance, is an essential mineral involved in muscle function that helps muscles to contract and relax. A few years ago, researchers in the United Kingdom found that 300 mg of supplemental magnesium reduced nighttime or nocturnal leg cramps in individuals who suffered chronic leg cramps. Like magnesium, potassium is an electrolyte found in your muscles. In fact, when your

What Causes a Muscle Cramp? What’s the Quickest Way to Get Relief?

muscles contract, they release potassium into the surrounding tissue. Chloride is an electrolyte that helps your body regulate the level of fluids in your body. Chloride is an important electrolyte to remember, since dehydration can be a contributing factor to muscle cramps.

Electrolytes are certain minerals that play an important role in muscle function. Low levels of any of these minerals can allow the muscle to contract, but prevent it from relaxing.
A second preventative measure, especially if you sweat in hot weather, exercise for long periods of time, or work in hot conditions, is to maintain adequate fluid intake. Dehydration can be life threatening, but did you know that mild dehydration reduces your blood volume, which, in turn, can reduce the supply of oxygen to your muscles? When the oxygen supply is reduced to the muscles, they can go into spasm. Be sure to drink plenty of fluids containing electrolytes during physical activity, or throughout the day if you are prone to nighttime cramps. Keep in mind, however, that many sports drinks can contain high quantities of sugar, which can lead to stomach distress during strenuous activity or excessive calorie intake during less active times.

If a cramp does occur, there are some steps you can take to relieve the pain. First, try stretching the affected muscles. For calf-muscle cramps, for instance, try stretching your calf muscle by pulling your toes towards your knees with the affected leg extended straight. Second, relax in a warm bath or take a hot shower (allowing water to hit the affected area) to help relax the muscle. Third, gently massage the affected area, being careful not to apply too much pressure. You can also apply an ice pack to the sore muscle to reduce pain and swelling. If the affected area still hurts, treat it like you would an injured muscle, which means resting the affected leg and avoiding any further muscle strain.

Finally, if you have chronic or severe leg cramps, contact your doctor. It may be the sign of a more serious condition, so it’s important to check with your physician first.

Sources:

Leg Cramps at Night. Electronic version available online at http://www.digitalnaturopath.com/cond/C466089.html.
Prevention Magazine. The Complete Book of Vitamins and Minerals, Rodale Press: New York, 1998, pp: 319-325.
Roffe C, Sills S, Crome P, Jones P. Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of persistent leg cramps. Med Sci Monit. 2002 8(5): CR326-30.

Electrolytes the spark plugs for your bike – by Val John Anderson

The human body has often been compared to a finely tuned engine. the engine that powers a bicycle is, of course, the human body, and the better that body runs and feels, the more performance and enjoyment one can experience while cycling. In keeping with the analogy of the human body as a finely tuned engine, if food or calories are the fuel in the gas tank, then electrolytes are the spark plugs. Electrolytes are also essential to the proper functioning of fluids in the body, which not only act as the body’s electrical system, but also as the cooling system and highway, delivering nutrients in and wastes out. Here’s a quick guide to understanding electrolytes and how they can take your customers’ riding to a new level.

Electrolytes are charged, water-soluble, essential minerals that make the body’s fluids electrically conductive. They govern a number of functions in the body including energy usage, regulating fluid balance and proper muscle function and are also essential to hydration.

Electrolytes influence energy on a number of levels within the body. First, they are essential carriers of energy. They generate and conduct energy. Second, they are essential converters of energy. Without electrolytes, the body cannot convert dormant energy into active energy. Third, the movement of electrolytes.

is a basic energy source tapped by the body. The energy in a battery is created by the movement of charged ions, i.e., electrolytes, and the body uses the same process.

The Electrolyte Team and Its Functions:

Magnesium Essential for all energy conversion as well as to the proper function of sodium, potassium, and calcium within the body. Essential for muscles, nerves, the cell pump, bones and teeth and pH balance. The most expensive major electrolyte.
Potassium The most abundant electrolyte in the cells. Essential for muscles, nerves, water balance and pH balance.
Sodium Commonly excessive in modern diets. Essential for thirst response, heat tolerance, muscle contraction, nerve conduction, water balance and pH balance. The least expensive electrolyte.
Calcium Essential for bones and teeth only. Small amounts in electrolyte form found in body fluids but it plays critical roles in that form.
Chloride The most abundant negative electrolyte (anion) in the body. Essential for oxygen exchange, digestion, water and pH balance.
Dehydration and Hyponatremia: Two Electrolyte Disturbances at Opposite Ends of the Spectrum

The body is constantly working to maintain a tight equilibrium of electrolytes, and there are many factors that can disrupt these levels and balance of electrolytes. (Hot temperatures, stress and physical exertion are just a few.) During high heat conditions and grueling rides, whenever a cyclist loses fluids, he or she is losing electrolytes. This loss of body water and essential electrolytes is dehydration. If a cyclist isn’t replacing electrolytes, the body will pull electrolytes from the tissues in order to meet its immediate demands. Therefore, it’s critical to replace lost fluids and electrolytes.

Signs of Dehydration:

Mild Dehydration: Dry lips and mouth, thirst, low urine output, headache and muscle cramping
Moderate Dehydration: Extreme thirst, very dry mouth, sunken eyes, tenting (pinch and lift skin light if it doesn’t bounce back readily, this is tenting), low or no urine output, lack of sweating and not producing tears
Severe Dehydration: All signs of moderate dehydration, rapid and weak pulse, cold hands and feet, rapid breathing, blue lips and lethargic / comatose / seizures.
Severe dehydration requires immediate hospitalization and causes imminent risk of death.

There is a consistent flow of electrolytes into the body through foods and beverages and out of the body through sweat, urine and feces. If the body is deficient, it will work harder to absorb and hold onto an essential electrolyte. If the body has an excessive level of an electrolyte or an overly high ratio of one electrolyte to another, it will work to offload that electrolyte and restore balance. Usage of electrolytes by the body also increases electrolyte excretion.

Electrolyte Replacement Tools

Sports Drinks

Pros: Usually taste good, combines source for electrolytes, fluids and calories. Electrolytes support hydration and conversion of sugar calories to energy.
Cons: Fixed ratio of electrolytes to fluids to sugars that may be problematic for certain individuals or situations. Read the label for the range and balance of electrolytes contained.
Gels

Pros: Can be an additional source of electrolytes, which support conversion of calories to active energy.
Cons: Fixed ratio of calories to electrolytes. Same potential problems as above.
Sugar-free Electrolyte Drinks

Pros: Generally taste good and can be a nice treat when sugar tolerance has been maxed out or for those who can’t tolerate or don’t like sugar.
Cons: Tend to have artificial ingredients.
Electrolyte Pills

Pros: Allows for large, quick dosing
Cons: Can be difficult to keep “fresh” or to handle and swallow on the go.
Pure Electrolyte Add-In

Pros: Can provide excellent value. Used to customize sports drinks and gels. Can make pure electrolyte water that doesn’t require extra clean up.
Cons: Some are sensitive to flavor and / or don’t want the effort to mix it with other beverages or foods.
Food is an excellent source for electrolytes. Processed foods can provide a lot of sodium. Fruits and juices can provide potassium. Green, leafy vegetables can provide magnesium. Dairy products can provide calcium. Foods today tend to be lower in magnesium and calcium than they were in generations past. Top athletes can now find it difficult to consume sufficient electrolytes through normal foods.

Guide your customers. Let them know that consuming an appropriate level and balance of electrolytes can elevate performance, endurance and the sheer enjoyment from cycling to an entirely new level.

Water + Electrolytes: How They Prevent Dehydration

Intense work or exercise in the heat and serious illness can quickly lead to dehydration. Drinking lots of fluid with electrolytes can prevent it. Here’s what you need to know about water, electrolytes, and why you shouldn’t reach for those calorie-dense, sugary-sweet sports drinks to meet your hydration needs.

Dehydration. You may have read or heard that if you’re working or exercising outdoors in hot temperatures or experiencing illness (such as vomiting and/or diarrhea), you need to stay hydrated and that the simplest solution is to drink plenty of water or an electrolyte-fortified beverage such as Gatorade®. Despite all of the attention focused on the dangers of dehydration, many people are unaware of this all-too-common condition, which can be fatal if one doesn’t recognize the signs.

To shed some light on the issue and clear up some common misunderstandings and misconceptions, this article explains why water is so important, what dehydration is, who’s at risk, and the three stages of dehydration. In addition, it discusses electrolytes, explaining what they are and how they, when coupled with fluid replacement, can prevent and treat dehydration. Finally, this article covers the issue of sports drinks. Despite their popularity amongst certain groups, sports drinks are a poor choice to stay hydrated. This article presents the limitations of many electrolyte-fortified beverages and why they fall short in meeting many people’s hydration needs.

Water: The Most Important Nutrient

Water is the most important nutrient for your body. On average, the human body is 60 percent water by weight, depending on certain factors such as age,gender,and bodyweight.1 The average 70kilogram(kg)(154lb.) man is made up of 42 liters (l) ( or ~11 gallons) of water while the average 55-kg (121 lb.) adult female is made up of 27.5 l (~7.2 gallons) of water. 1

Within the body, water is divided between two major fluid compartments—40 to 50 percent of total body water is contained within the cells, called intracellular fluid; 50 to 60 percent is outside the cells (extracellular fluid).

So, why is water so important? It performs numerous important biological functions in the body. First, at the cellular level, it provides structural firmness.1 Second, water makes up blood, lymph, gastric secretions, and urine. It helps lubricate our joints (synovial fluid), which allows bones to move freely against each other.2

It also forms blood plasma, which transports oxygen, glucose, and amino acids to active muscle and tissue while carrying away carbon dioxide and lactic acid. During exercise, muscles produce lactic acid (plus other acids), and too much lactic acid can impair muscle contractility and performance. Third, water helps maintain core body temperature (thermoregulation). Your body uses water as a cooling mechanism (through sweating) to adequately control its temperature. Even in moderately warm weather, significant amounts of water are lost through sweat.1 Under more arduous training conditions, it’s estimated that sweat losses in endurance athletes exercising in heat and humidity can be nearly 3 liters per hour.1

Dehydration Defined

Even a mild deficit of water can have a substantial impact on well-being, exercise performance, and attentiveness. Defined, dehydration is the loss of body water and important ions (blood salts like potassium and magnesium). It simply means your body doesn’t have as much water and electrolytes as it should have, which interferes with normal body processes.

It’s easy to become dehydrated, and you don’t have to run a marathon to become dehydrated. Each day you lose approximately two to two-and-a-half cups (450 to 600 ml) of water just going about your usual activities, so it is important to replace fluid losses throughout the day. Coffee, tea, and sodas are not an ideal choice. These beverages have a diuretic effect (i.e., trigger water loss) and actually increase your daily fluid requirement.

The current RDA for water for adults at rest under average conditions of environmental exposure is 1 ml/kcal of energy expenditure.3 For women, this amount would equal 2.2 l/day; for men, 2.9 l/day.3

Who’s At Risk?

Any individual can become dehydrated from the following conditions:

  • Excessive sweating (e.g., endurance exercise, working outdoors, etc.)
  • Vomiting and/or diarrhea
  • Fever
  • Excessive urine output (e.g., uncontrolled diabetes, diuretic medications).

Infants, children, pregnant and breastfeeding women, those experiencing illness, and elderly adults have increased needs for water.3 Infants and children, because of their smaller size and weight, can quickly become dangerously dehydrated if they’re experiencing vomiting, diarrhea, fever, and refuse to eat or drink anything.

Excessive vomiting and diarrhea (lasting longer than 24 hours) is a cause for concern and is a risk factor for dehydration. Usually, the best way to treat it is to increase fluid intake to replace fluids lost through diarrhea/vomiting. In addition, one can also add a rehydration solution, which can be sipped on every two or three minutes. If, however, a baby or adult is showing signs of dehydration (see below), one should seek medical attention immediately.

Elderly adults are another group at risk for dehydration because the thirst desire is reduced as people age. It’s imperative that elderly adults (especially those who live in hot climates and/or who do not air-conditioning) drink plenty of fluids before they become thirsty.

There are three classifications of dehydration: mild, moderate, and severe with each classification based on the amount of fluid lost from the body and not replaced.

 

Mild Dehydration4

The symptoms of mild dehydration are as follows:

  • Thirst
  • Dry lips and mouth
  • Inside of mouth slightly dry
  • Low urine output; concentrated urine appears dark yellow

Moderate Dehydration4

The signs of moderate dehydration include:

  • Thirst
  • Very dry mouth
  • Sunken eyes
  • Sunken fontanelles (the soft spots on an infant’s head)
  • Tenting (pinch and lift skin lightly—if it doesn’t bounce back readily)
  • Low or no urine output
  • Not producing tears.

At these signs, children under the age of 12 should see a physician immediately.

Severe Dehydration4

Signs of severe dehydration include:

  • All signs of moderate dehydration
  • Rapid and weak pulse
  • Cold hands and feet
  • Rapid breathing
  • Blue lips
  • Lethargic, comatose, seizures

Severe dehydration requires immediate hospitalization.

How to Monitor Your Hydration Status

Thirst is a signal that your body needs fluid; however, it’s a poor indicator of your body’s fluid needs because you can lose two percent of your body weight before you feel thirsty.

A better way to gauge your hydration status is to monitor the output and color of your urine. A well-hydrated individual should void 1,000 to 1,500 ml/day, and urine color should be no darker than a pale yellow color.1 If your urine is darker, it is a sign you are dehydrated, and you need to increase your fluid intake.

Dehydration’s Effect on Exercise Performance

Those who work exercise in intense temperatures need to stay hydrated. Athletes should rely on urine output and color or checking their body weight both before and after each exercise session or event to gauge water losses. Ideally, athletes should replace approximately 1 liter of water per kg of weight lost (or ~2 cups/lb).5

Even mild water losses can significantly impede performance. For every one percent of body weight lost, blood volume decreases by 2.5 percent, muscle water decreases by one percent, and the body’s core temperature can increase 0.4 to 0.5° C.7 Changes in blood volume during prolonged exercise impair the body’s ability to deliver oxygen and key nutrients to active muscles, organs, and glands and negatively affect thermoregulation (the body’s ability to regulate core body temperature) by diminishing the body’s ability to expel heat. Losses of three percent are associated with physiological changes, such as decreased blood volume, decreased urine output, diminished performance, and decreased endurance, while losses of nine to twelve percent are fatal.1,7

 

Electrolytes are certain minerals (i.e., calcium, chloride, magnesium, potassium, sodium ions) essential to human health…and cannot be substituted by any other nutrient in the diet.

What Are Electrolytes?

No discussion of dehydration would be complete without an explanation of electrolytes and their respective functions. Most people, when asked, aren’t sure what electrolytes are or why they’re so important in preventing dehydration.

Electrolytes are certain minerals (i.e., calcium, chloride, magnesium, potassium, sodium ions) essential to human health. As an essential mineral, an electrolyte cannot be substituted by any other nutrient in the diet. That means that your body will only accept that particular mineral or electrolyte.

Without electrolytes, you could not move, think, or live. Within the body, electrolytes are dissolved in body fluids. In terms of hydration, electrolytes are responsible for directing water (and nutrients) to the areas of the body where its needed most and maintaining optimal fluid balance inside the cells. Besides maintaining fluid balance, electrolytes help your muscles to contract and relax and assist in the transmission of nerve impulses from your nervous system to different body parts.

The chart below explains the important functions electrolytes perform in your body:

Fig. 1: How Electrolytes Help Prevent/Treat Dehydration

SODIUM POTASSIUM
HYDRATES:

Maintains water balance;
Activates thirst response;
Prevents water intoxication & hyponatremia

PREVENTS CRAMPS:

Enables normal muscle contraction

ALSO:

Influences performance of other minerals; Enables nerve impulse transmission Maintains normal blood pressure

HYDRATES:

Maintains water balance

ENERGIZES:

Stimulates metabolism of proteins & carbohydrates;
Helps muscles use glycogen, their main source of energy

PREVENTS CRAMPS

Prevents muscle fatigue;
Enables normal muscle contraction;

 

ALSO:

Influences performance of other minerals; Enables nerve impulse transmission; Maintains normal blood pressure

CHLORIDE MAGNESIUM
HYDRATES:

Maintains water balance; Prevents dehydration

ENERGIZES:
Helps the body break down protein, absorb minerals & vitamin B12

PREVENTS CRAMPS:

Enables normal muscle contraction & relaxation

ALSO:

Enables nerve impulse transmission

ENERGIZES:

Participates in the conversion of ATP (adenosine triphosphate), which are the energy packets the body uses to produce and store energy; Stimulates the metabolism of carbohydrates & fats;

Helps the body build proteins

PREVENTS CRAMPS:

Decreases pain from sports-related injuries & excessive physical activity;
Enables normal muscle relaxation;
Prevents muscle cramps & spasms

ALSO:

Influences performance of other minerals; Enables nerve impulse transmission; Decreases vulnerability to disease;
Alleviates symptoms of numerous medical and psychiatric conditions

Besides the functions listed above, studies show that repletion of one important electrolyte—magnesium—has a significant impact on athletic performance. Moderately trained athletes who took magnesium supplements showed decreased blood pressure, heart rate, and oxygen intake. Triathletes supplementing with extra magnesium demonstrated improved cycling, swimming, and running times.8

Population studies consistently show that most adults do not get enough magnesium in their diet.

Don’t Count on Sports Drinks to Stay Hydrated

Sports drinks are often touted as the ideal way to prevent dehydration. Many claim to hydrate the body “better” than water, and, now, many contain a host of novel ingredients including vitamins, herbs, and caffeine, which claim to boost athletic performance. But are sports drinks more effective in hydrating the body than water?

Make no mistake—sports drinks are adult Kool-Aid with some sodium and, in some instances, potassium added. Sports drinks are loaded with sugar, and many athletes find them overwhelming when consumed during an event or exercise. Many commercial sports drinks are flavored (and colored) with chemicals and sweetened with high fructose corn syrup, a simple sugar that can cause fluctuations in blood sugar.

The most common complaints with sports drinks is stomach upset and a “mucous-y” or “gagging” sensation in the back of the throat. Electrolytes—not sugar—support hydration to the cellular level, and with sports drinks, you will max out on sugar before you’re adequately hydrated.

If you compared the grams of sugar (carbs) found in a typical 16- oz. serving of several leading brands of sports drinks with the carb content found in your average Tootsie Roll, you would discover the following:

  • Gatorade® contains 100 calories and 28 grams of carbs, which is equivalent to 13 Tootsie Rolls.
  • Powerade® contains 34 grams of carbs, equivalent to 16 Tootsie Rolls.
  • Endurox R-4 (Fruit Punch) contains 360 calories and 69 grams of carbs, equal to 33 Tootsie Rolls.

Incidentally, a 16 oz.- serving of Kool-Aid* provides roughly the same amount of calories and carbs per ounce as sports drinks (120 calories and 32 grams of carbs, roughly equivalent to 15 Tootsie Rolls), yet it also provides ten percent of the RDA for vitamin C.

The sugar content alone restricts the use of sports drinks for people with diabetes, which is highly telling. Besides the effect of sports drinks on blood-sugar levels, the long-term effects of the sweeteners, coloring agents, and other chemicals in sports drinks is not known, but some recent research does raise some questions. A 2005 study published in General Dentistry reported that some popular sports and energy drinks destroyed tooth enamel more effectively than cola. The study, which analyzed the effects of exposed dental enamel to 12 different brands of soft drinks, non-cola, and sports beverages, found that irreversible enamel damage was three to eleven times greater among the non-cola and sports beverages than cola-based drinks. 9

A second limitation of sports drinks is their electrolyte balance. Many claim to contain electrolytes to replace sweat losses, but the fact is, the primary electrolytes these beverages contain are sodium and potassium, and that’s it. Most people already get too much sodium from foods. The electrolyte content of Gatorade is 220 mg of sodium and 60 mg of potassium, based on a 16 oz. serving size. Powerade contains 110 mg of sodium and 60 mg of potassium. Gatorade’s latest product introduction, Endurance, which claims to have five electrolytes, contains a whopping 400 mg of sodium and 180 mg of potassium. What about the other electrolytes? Calcium and magnesium are mentioned; however, Endurance provides less than two percent of the Daily Value for these two critical electrolytes.

A balance of ALL electrolytes is necessary to maintain optimal hydration and endurance. Not only do you lose sodium in sweat, but you also lose other critical electrolytes like magnesium, and since most people don’t get enough magnesium, serious deficits can be occurring.

The bottom line is don’t count on plain water and sports drinks to meet your body’s hydration and electrolyte needs. Plain water (including bottled “mineral waters”) doesn’t contain a substantial quantity or balance of the essential electrolytes you require to stay adequately hydrated, replace electrolytes lost in sweat, and maintain optimum performance. As for sports drinks, the high-sugar content of most of these beverages often causes bloating, stomach cramps, and can impair your hard-fought training and performance at the moment when it may matter the most.

ELETE is an electrolyte add-in you add to water or any other beverage to make an instant sports drink. It provides pure electrolytes and nothing else. ELETE powers rapid hydration and quickly replaces ALL lost electrolytes—not just sodium. It supports performance, stamina, and recovery, and delivers electrolytes evenly to ensure optimal hydration. ELETE allows you, the user, the option of consuming carbohydrates in whatever way works best for you. And unlike sugar-loaded sports drinks, ELETE doesn’t contain calories, flavorings, sweeteners, colors or sugar, which can hinder performance.

 

References:

  1. Taylor PN, Wolinsky, I., Klimis DJ (1999). Water in Exercise and Sport in Macroelements, Water, and Electrolytes, , JA Driskell and Wolinsky I, Eds.,CRC Press, Boca Raton, FL: chap.5.
  2. Christian JL and Greger JL (1994). In Nutrition for Living, 4th ed., Benjamin/Cummings, Redwood City, CA: chap.4.
  3. National Research Council (1989). Water and Electrolytes, In Recommended Dietary Allowances, 10th ed., National Academy of Sciences, Washington, D.C., chap. 11.
  4. Meletis, CM (2002). Dehydration: An Imbalance of Water and Electrolytes. Ogden, UT: By license to Mineral Resources International. 
  5. Clark, N (1997). In Nancy Clark’s Sports Nutrition Guidebook, 2nd ed., Human Kinetics, Champaign, IL, chap. 9.
  6. Hultman E, Harris RC, Spriet LL. (1994). Work and exercise, In Modern Nutrition in Health and Disease, 8th ed., Shilds ME, Olson JA, and Shike M., Eds., Lea & Febiger, Philadelphia, PA: chap. 42.
  7. Wilmore JH and Costill DL (1994). In Physiology of Sport and Exercise, Human Kinetics, Champaign, IL:chap. 15.
  8. Seelig, MS(2001). Human Needs for Magnesium are Not Met by Most People. Ogden, UT: Mineral Resources International.
  9. von Fraunhofer AJ, Rogers MM. Effects of sports drinks and other beverages on dental enamel. General Dentistry 

2005;53(1):308-312.
© 2006. All rights reserved.

The clinical studies and research cited in this article is for information purposes only and does not constitute an endorsement of ELETE.

*Sample products compared were Gatorade Berry Citrus, Powerade Fruit Punch, and Kool-Aid Sugar- Sweetened Soft Drink, Grape Flavor.

**Gatorade, Powerade, and Kool-Aid are registered trademarks. Comparison based on 16-oz. serving.

Hyponatremia: Are Salt Tablets Sufficient to Prevent a Salt Deficiency?

Many athletes as well as others exposed to heat stress consume salt supplements to promote fluid replacement, prevent hyponatremia and dehydration, or ward off heat fatigue. While it is true that supplementing with salt can help reduce sodium depletion from sweat and help maintain adequate fluid levels in the body, supplementing with sodium alone is not enough to satisfy your body’s electrolyte requirements and, in fact, may cause additional problems (e.g., nausea, vomiting, muscle cramps) that significantly interfere with performance.

Rather, a normal water and electrolyte balance, including an intake of other electrolytes such as magnesium, potassium, and chloride, is essential for maintaining the normal function of the body’s systems during physical activity.

Hyponatremia—What is it?

Many athletes will take salt supplements to prevent hyponatremia, which is a low concentration of sodium in the blood. In spite of the abundance of negative press that salt has received, sodium and chloride (NaCl) are both essential minerals.

Hyponatremia is the predominant electrolyte disturbance.1 In healthy individuals, the normal range for serum sodium is 137-147 mEq/L. In hyponatremic individuals, serum sodium levels fall below 137 mEq/L.2 Hyponatremia has killed seemingly healthy individuals every year, yet it can also be less severe but still significantly impede performance. Common symptoms include weakness, agitation, confusion, nausea, or vomiting. Hyponatremia may occur when there is an excessive consumption of water, which dilutes electrolytes in the body, and/or through sweat- induced or other electrolyte loss.

Hyponatremia strikes most often in marathoners or triathletes during long or ultra- distance races in the heat; however, it can happen any time during extended periods of physical activity when an athlete consumes too much fluid and not enough electrolytes. During a Hawaiian Ironman Triathlon, hyponatremia occurred in nearly 30 percent of the triathletes.3

The two primary risk factors for developing hyponatremia are excessive fluid consumption and longer finishing times.4

Salt Supplements—Should You Take Them with a Grain of Salt?

Sodium (Na) is the predominant cation (positively charged element) found in extracellular fluid. It is important in maintaining the proper acid-base balance and in the transmission of nerve impulses.5 Sodium teams with potassium, the chief cation of intracellular fluid, to maintain proper body fluid and acid-base balance in the cells and tissue and maintain blood pressure. Potassium and other electrolytes—such as magnesium and chloride—perform numerous, multifaceted roles in the body. They work in concert with sodium to regulate acid-base, electrolyte, and water balance; conduct nerve impulses; promote normal muscle contraction (including the heartbeat); regulate the transfer of nutrients to cells; and maintain the normal function of the kidneys, heart, and nerve cells. An imbalance of any electrolyte can have far-reaching, serious effects within the body.5

Often, salt tablets and sodium-enhanced beverages, which are touted as electrolyte- replacement beverages, are promoted as an ideal way to replenish the salt that is lost through sweat. There are, however, additional electrolytes that, in conjunction with sodium, are also lost in sweat and this is one of the limitations of salt tablets and many electrolyte-replacement beverages.

An imbalance of any electrolyte can have far-reaching, serious effects within the body.

Of the 21 hyponatremic runners who sought aid in the 2000 Houston Marathon, an analysis of their serum electrolytes also revealed lower potassium and chloride levels than non-hyponatremic runners.4

Returning to the Hawaiian Ironman study that reported a 30 percent incidence of hyponatremia among athletes, researchers also discovered that 20 percent had hypomagnesaemia (low serum magnesium).3

Besides the fact that low electrolyte levels may contribute to hyponatremia, they can also contribute to other performance-induced problems such as muscle cramping and fatigue. One study that analyzed the effects of dehydration on water and electrolyte levels in the body found a 12 percent decrease in muscle magnesium correlating with 5.8 percent dehydration while muscle sodium and chloride levels remained unchanged.6 One of the primary functions of magnesium is that it activates ATP (adenosine triphosphate), which is the energy-carrying molecule the body uses for all forms of energy. A large loss of magnesium in the muscle could interfere with ATP generation, leading to fatigue. Low magnesium levels are also associated with both spasms and cramping.7

If, as some studies suggest, hyponatremia is also associated with lower levels of other electrolytes, how effective is it to supplement with salt rather than a balance of electrolytes?

It has been shown in at least one study that supplementation with salt tablets, i.e., sodium chloride alone, is insufficient to significantly influence changes in serum sodium and plasma volume.8

In addition, taking salt tablets during high-endurance activities can often cause a host of unpleasant to debilitating side effects. Concentrated salt tablets may actually encourage or exacerbate dehydration by lowering the level of water in the blood. Salt tablets can cause water to be pulled from surrounding body tissues (where it is needed during high-endurance activity) into the stomach in order to dilute the salt. For the athlete, the result can be stomach cramps, nausea, or, worse, vomiting.

Additional complications arising from supplementing with sodium alone are imbalanced electrolyte levels. Increased sodium can negatively affect potassium and magnesium levels, which, consequently, could reduce exercise performance and contribute to cramping.

Guidelines for Fluid Replacement

The American College of Sports Medicine (ACSM) recommends that individuals consume 500 ml (~ 17 oz.) of fluid two hours before exercise and that they continue to consume cool drinks in regular intervals to replace water lost through sweating or the maximum amount that can be tolerated. ACSM also recommends adding electrolytes to fluid for prolonged intense exercise lasting longer than one hour.9-10

The best way to replace fluids and the balance of electrolytes lost through sweat is to drink water fortified with ELETE, a pure electrolyte add-in. Why? Electrolytes and water are assimilated in balance with each other, function in balance collectively, and, as the studies cited above demonstrate, are excreted en masse. Therefore, the best way to prevent an electrolyte or fluid imbalance, which can have catastrophic effects, is to consume fluid and electrolytes in proper balance with each other.

Water and Electrolytes, A Winning Combination

In 2004, a study of ELETE was conducted though the University of Montana’s Human Performance Laboratory to determine the effects of water alone compared with water and ELETE under the most severe environmental, physiological, and psychological endurance conditions possible—wildland fire suppression.11Wildland firefighters work very long shifts (just under 15 hours in the ELETE study) in the most extreme of conditions. Often, the total body energy expenditure of a firefighter can increase 3.6 times the basal metabolic rate. Due to the highly physical nature of the job, the hydration demand is significant; however, immediate water availability can be problematic due to the logistics associated with transporting water. In addition to extreme temperatures and physical work involved with fire suppression, the demands of the job, itself, are constant and unending—a typical assignment may last up to a week or more.

The ELETE study revealed the effectiveness of adding ELETE to normal drinking water under arduous working conditions.

By consuming ELETE with water during an event or when exposed to heat stress, the individual is metering the consumption of electrolytes with fluids, which reduces the rate of electrolyte depletion and enhances hydration.

Two specific study details include the following:11

  • Fire fighters who consumed water alone had to consume significantly higher amounts of water in order to achieve the same level of hydration as the ELETE group.
  • The total water intake was 3.2 liters less per person over a day for the ELETE group.

In other words, the water-only group had to consume more water to maintain whole body hydration and body weight. To apply this study to athletes and outdoor enthusiasts, when people are in an endurance sport or intense heat-stress situation, the key to optimal performance is to maintain adequate hydration so as to support the body’s cooling system and not lower electrolyte levels to the point where they become dangerously low or impair performance.

By consuming ELETE with water during an event or when exposed to heat stress, the individual is metering the consumption of electrolytes with fluids, which reduces the rate of electrolyte depletion and enhances hydration. In the ELETE clinical study, it was shown that those who consumed water alone had to consume 74 percent more water than those who drank water with ELETE in order to achieve the same level of hydration. This benefit is compounded when attempting to prevent hyponatremia because athletes can achieve the same level of hydration with significantly less fluids thus reducing dilution of electrolytes.

 

References:

  1. Hiller WD. Dehydration and hyponatremia during triathlons. Med Sci Sports Exerc. 1989 Oct; 21(5 Suppl): S219-21.
  2. Horne MM and Swearingen PL. Fluids, Electrolytes, and Acid-Base Balance, Mosby—Year Book, Inc., St. Louis, MO, 1993, 89.
  3. O’Toole Ml, Douglas PS, Laird RH, Hiller DB. Fluid and electrolyte status in athletes receiving medical care at an ultradistance triathlon. Clin J Sport Med. 1995; 5(2):116-22.
  4. Hew TD, Chorley JN, Cianca JC, Divine JG. The incidence, risk factors, and clinical manifestations of hyponatremia in marathon runners. Clin J Sport Med. 2003 Jan; 13(1):41-7.
  5. National Research Council, Recommended Dietary Allowances, National Academy Press, Washington, D.C., 1989.
  6. Costill DL, Cote R, Fink W. Muscle water and electrolytes following varied levels of dehydration in man. J Appl Physiol. 1976 Jan; 40(1):6-11.
  7. Brilla LR and Lombardi VP. Magnesium in exercise and sport, in Macroelements, Water, and Electrolytes, Driskell, J.A., and Wolinsky I., Eds. CRC Press, Boca Raton, FL, 1999, chap.4.
  8. Speedy DB, Thompson JM, Rodgers I, Collins M, Sharwood K, Noakes TD. Oral salt supplementation during ultradistance exercise. Clin J Sport Med. 2002 Sep; 12(5):279-84.
  9. Convertino VA, Armstrong LE, Coyle EF, Mack GW, Sawka MN, Senay LC Jr., Sherman WM. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 1996 Jan; 28(1): I-vii).
  10. Von Duvillard SP, Braun WA, Markofski M, Beneke R, Leithauser R. Fluids and hydration in prolonged endurance performance. Nutrition. 2004 Jul-Aug; 20(7- 8):651-6.
  11. Ruby, BC. “Effects of water and water + electrolytes on changes in body temperature, hydration status and drinking behaviors during arduous wildfire suppression.” Mineral Resources International, Ogden, UT, 2004.