Skip to main content
Top
Published in: Journal of the International Society of Sports Nutrition 1/2012

Open Access 01-12-2012 | Research article

Ad libitum fluid intake leads to no leg swelling in male Ironman triathletes – an observational field study

Authors: Michael Meyer, Beat Knechtle, Jolanda Bürge, Patrizia Knechtle, Claudia Mrazek, Andrea Wirth, Birte Ellenrieder, Christoph Alexander Rüst, Thomas Rosemann

Published in: Journal of the International Society of Sports Nutrition | Issue 1/2012

Login to get access

Abstract

Background

An association between fluid intake and limb swelling has been described for 100-km ultra-marathoners. We investigated a potential development of peripheral oedemata in Ironman triathletes competing over 3.8 km swimming, 180 km cycling and 42.2 km running.

Methods

In 15 male Ironman triathletes, fluid intake, changes in body mass, fat mass, skeletal muscle mass, limb volumes and skinfold thickness were measured. Changes in renal function, parameters of skeletal muscle damage, hematologic parameters and osmolality in both serum and urine were determined. Skinfold thicknesses at hands and feet were measured using LIPOMETER® and changes of limb volumes were measured using plethysmography.

Results

The athletes consumed a total of 8.6 ± 4.4 L of fluids, equal to 0.79 ± 0.43 L/h. Body mass, skeletal muscle mass and the volume of the lower leg decreased (p <0.05), fat mass, skinfold thicknesses and the volume of the arm remained unchanged (p >0.05). The decrease in skeletal muscle mass was associated with the decrease in body mass (p <0.05). The decrease in the lower leg volume was unrelated to fluid intake (p >0.05). Haemoglobin, haematocrit and serum sodium remained unchanged (p >0.05). Osmolality in serum and urine increased (p <0.05). The change in body mass was related to post-race serum sodium concentration ([Na+]) (r = −0.52, p <0.05) and post-race serum osmolality (r = −0.60, p <0.05).

Conclusions

In these Ironman triathletes, ad libitum fluid intake maintained plasma [Na+] and plasma osmolality and led to no peripheral oedemata. The volume of the lower leg decreased and the decrease was unrelated to fluid intake. Future studies may investigate ultra-triathletes competing in a Triple Iron triathlon over 11.4 km swimming, 540 km cycling and 126.6 km running to find an association between fluid intake and the development of peripheral oedemata.
Appendix
Available only for authorised users
Literature
1.
go back to reference Williams ES, Ward MP, Milledge JS, Withey WR, Older MW, Forsling ML: Effect of the exercise of seven consecutive days hill-walking on fluid homeostasis. Clin Sci. 1979, 56: 305-331.CrossRefPubMed Williams ES, Ward MP, Milledge JS, Withey WR, Older MW, Forsling ML: Effect of the exercise of seven consecutive days hill-walking on fluid homeostasis. Clin Sci. 1979, 56: 305-331.CrossRefPubMed
2.
go back to reference Milledge JS, Bryson EI, Catley DM, Hesp R, Luff N, Minty BD, Older MW, Payne NN, Ward MP, Withey WR: Sodium balance, fluid homeostasis and the renin-aldosteronsystem during the prolonged exercise of hill walking. Clin Sci (Lond). 1982, 62: 595-604.CrossRef Milledge JS, Bryson EI, Catley DM, Hesp R, Luff N, Minty BD, Older MW, Payne NN, Ward MP, Withey WR: Sodium balance, fluid homeostasis and the renin-aldosteronsystem during the prolonged exercise of hill walking. Clin Sci (Lond). 1982, 62: 595-604.CrossRef
3.
go back to reference Fellmann N, Ritz P, Ribeyre J, Beaufrère B, Delaître M, Coudert J: Intracellular hyperhydration induced by a 7-day endurance race. Eur J Appl Physiol. 1999, 80: 353-359. 10.1007/s004210050603.CrossRef Fellmann N, Ritz P, Ribeyre J, Beaufrère B, Delaître M, Coudert J: Intracellular hyperhydration induced by a 7-day endurance race. Eur J Appl Physiol. 1999, 80: 353-359. 10.1007/s004210050603.CrossRef
4.
go back to reference Knechtle B, Senn O, Imoberdorf R, Joleska I, Wirth A, Knechtle P, Rosemann T: Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race. Asia Pac J Clin Nutr. 2010, 19: 83-90.PubMed Knechtle B, Senn O, Imoberdorf R, Joleska I, Wirth A, Knechtle P, Rosemann T: Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race. Asia Pac J Clin Nutr. 2010, 19: 83-90.PubMed
5.
go back to reference Knechtle B, Wirth A, Knechtle P, Rosemann T: Increase of total body water with decrease of body mass while running 100 km nonstop-formation of edema?. Res Q Exerc Sport. 2009, 80: 593-603. 10.5641/027013609X13088500159769.CrossRefPubMed Knechtle B, Wirth A, Knechtle P, Rosemann T: Increase of total body water with decrease of body mass while running 100 km nonstop-formation of edema?. Res Q Exerc Sport. 2009, 80: 593-603. 10.5641/027013609X13088500159769.CrossRefPubMed
6.
go back to reference Knechtle B, Duff B, Schulze I, Kohler G: A multi-stage ultra-endurance run over 1,200 km leads to a continuous accumulation of total body water. J Sports Sci Med. 2008, 7: 357-364.PubMed Knechtle B, Duff B, Schulze I, Kohler G: A multi-stage ultra-endurance run over 1,200 km leads to a continuous accumulation of total body water. J Sports Sci Med. 2008, 7: 357-364.PubMed
7.
go back to reference Knechtle B, Knechtle P, Rosemann T, Oliver S: A Triple Iron triathlon leads to a decrease in total body mass but not to dehydration. Res Q Exerc Sport. 2010, 81: 319-327. 10.5641/027013610X13088573596267.CrossRefPubMed Knechtle B, Knechtle P, Rosemann T, Oliver S: A Triple Iron triathlon leads to a decrease in total body mass but not to dehydration. Res Q Exerc Sport. 2010, 81: 319-327. 10.5641/027013610X13088573596267.CrossRefPubMed
8.
go back to reference Knechtle B, Vinzent T, Kirby S, Knechtle P, Rosemann T: The recovery phase following a Triple Iron triathlon. J Hum Kin. 2009, 21: 65-74. 10.2478/v10078-09-0008-3. Knechtle B, Vinzent T, Kirby S, Knechtle P, Rosemann T: The recovery phase following a Triple Iron triathlon. J Hum Kin. 2009, 21: 65-74. 10.2478/v10078-09-0008-3.
9.
go back to reference Maughan RJ, Whiting PH, Davidson RJ: Estimation of plasma volume changes during marathon running. Brit J Sports Med. 1985, 19: 138-141. 10.1136/bjsm.19.3.138.CrossRef Maughan RJ, Whiting PH, Davidson RJ: Estimation of plasma volume changes during marathon running. Brit J Sports Med. 1985, 19: 138-141. 10.1136/bjsm.19.3.138.CrossRef
10.
go back to reference Mischler I, Boirie Y, Gachon P, Pialoux V, Mounier R, Rousset P, Coudert J, Fellmann N: Human albumin synthesis is increased by an ultra-endurance trial. Med Sci Sports Exerc. 2003, 35: 75-81. 10.1097/00005768-200301000-00013.CrossRefPubMed Mischler I, Boirie Y, Gachon P, Pialoux V, Mounier R, Rousset P, Coudert J, Fellmann N: Human albumin synthesis is increased by an ultra-endurance trial. Med Sci Sports Exerc. 2003, 35: 75-81. 10.1097/00005768-200301000-00013.CrossRefPubMed
11.
go back to reference Lehmann M, Huonker M, Dimeo F: Serum amino acid concentrations in nine athletes before and after the 1993 Colmar Ultra Triathlon. Int J Sports Med. 1995, 16: 155-159. 10.1055/s-2007-972984.CrossRefPubMed Lehmann M, Huonker M, Dimeo F: Serum amino acid concentrations in nine athletes before and after the 1993 Colmar Ultra Triathlon. Int J Sports Med. 1995, 16: 155-159. 10.1055/s-2007-972984.CrossRefPubMed
12.
go back to reference Uberoi HS, Dugal JS, Kasthuri AS, Kolhe VS, Kumar AK, Cruz SA: Acute renal failure in severe exertional rhabdomyolysis. J Assoc Physicians India. 1991, 39: 677-679.PubMed Uberoi HS, Dugal JS, Kasthuri AS, Kolhe VS, Kumar AK, Cruz SA: Acute renal failure in severe exertional rhabdomyolysis. J Assoc Physicians India. 1991, 39: 677-679.PubMed
13.
go back to reference Wade CE, Dressendorfer RH, O’Brien JC, Claybaugh JR: Renal function, aldosterone, and vasopressin excretion following repeated long-distance running. J Appl Physiol. 1981, 50: 709-712.PubMed Wade CE, Dressendorfer RH, O’Brien JC, Claybaugh JR: Renal function, aldosterone, and vasopressin excretion following repeated long-distance running. J Appl Physiol. 1981, 50: 709-712.PubMed
14.
go back to reference Lund-Johansen P, Stranden E, Helberg S, Wessel-Aas T, Risberg K, Rønnevik PK, Istad H, Madsbu S: Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine. J Hypertens. 2003, 21: 1003-1010. 10.1097/00004872-200305000-00026.CrossRefPubMed Lund-Johansen P, Stranden E, Helberg S, Wessel-Aas T, Risberg K, Rønnevik PK, Istad H, Madsbu S: Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine. J Hypertens. 2003, 21: 1003-1010. 10.1097/00004872-200305000-00026.CrossRefPubMed
15.
go back to reference Bracher A, Knechtle B, Gnädinger M, Bürge J, Rüst CA, Knechtle P, Rosemann T: Fluid intake and changes in limb volumes in male ultra-marathoners: does fluid overload lead to peripheral oedema?. Eur J Appl Physiol. 2012, 112: 991-1003. 10.1007/s00421-011-2056-3.CrossRefPubMed Bracher A, Knechtle B, Gnädinger M, Bürge J, Rüst CA, Knechtle P, Rosemann T: Fluid intake and changes in limb volumes in male ultra-marathoners: does fluid overload lead to peripheral oedema?. Eur J Appl Physiol. 2012, 112: 991-1003. 10.1007/s00421-011-2056-3.CrossRefPubMed
16.
go back to reference Jürimäe T, Jürimäe J, Wallner SJ, Lipp RW, Schnedl WJ, Möller R, Tafeit E: Relationships between body fat measured by DXA and subcutaneous adipose tissue thickness measured by Lipometer in adults. J Physiol Anthropol. 2007, 26: 513-516. 10.2114/jpa2.26.513.CrossRefPubMed Jürimäe T, Jürimäe J, Wallner SJ, Lipp RW, Schnedl WJ, Möller R, Tafeit E: Relationships between body fat measured by DXA and subcutaneous adipose tissue thickness measured by Lipometer in adults. J Physiol Anthropol. 2007, 26: 513-516. 10.2114/jpa2.26.513.CrossRefPubMed
17.
go back to reference Tafeit E, Greilberger J, Cvirn G, Lipp RW, Schnedl WJ, Jürimäe T, Jürimäe J, Wallner-Liebmann SJ: Estimating DXA total body fat percentage by lipometer subcutaneous adipose tissue thicknesses. Coll Antropol. 2009, 33: 391-396.PubMed Tafeit E, Greilberger J, Cvirn G, Lipp RW, Schnedl WJ, Jürimäe T, Jürimäe J, Wallner-Liebmann SJ: Estimating DXA total body fat percentage by lipometer subcutaneous adipose tissue thicknesses. Coll Antropol. 2009, 33: 391-396.PubMed
18.
go back to reference Möller R, Tafeit E, Smolle KH, Pieber TR, Ipsiroglu O, Duesse M, Huemer C, Sudi K, Reibnegger G: Estimating percentage total body fat and determining subcutaneous adipose tissue distribution with a new noninvasive optical device LIPOMETER. Am J Hum Biol. 2000, 12: 221-230. 10.1002/(SICI)1520-6300(200003/04)12:2<221::AID-AJHB8>3.0.CO;2-2.CrossRefPubMed Möller R, Tafeit E, Smolle KH, Pieber TR, Ipsiroglu O, Duesse M, Huemer C, Sudi K, Reibnegger G: Estimating percentage total body fat and determining subcutaneous adipose tissue distribution with a new noninvasive optical device LIPOMETER. Am J Hum Biol. 2000, 12: 221-230. 10.1002/(SICI)1520-6300(200003/04)12:2<221::AID-AJHB8>3.0.CO;2-2.CrossRefPubMed
19.
go back to reference Skenderi KP, Kavouras SA, Anastasiou CA, Yiannakouris N, Matalas AL: Exertional rhabdomyolysis during a 246-km continuous running race. Med Sci Sports Exerc. 2006, 38: 1054-1057. 10.1249/01.mss.0000222831.35897.5f.CrossRefPubMed Skenderi KP, Kavouras SA, Anastasiou CA, Yiannakouris N, Matalas AL: Exertional rhabdomyolysis during a 246-km continuous running race. Med Sci Sports Exerc. 2006, 38: 1054-1057. 10.1249/01.mss.0000222831.35897.5f.CrossRefPubMed
20.
go back to reference Knechtle B, Kohler G: Running 338 kilometres within five days has no effect on body mass and body fat but reduces skeletal muscle mass - The Isarrun 2006. J Sports Sci Med. 2007, 6: 401-407.PubMed Knechtle B, Kohler G: Running 338 kilometres within five days has no effect on body mass and body fat but reduces skeletal muscle mass - The Isarrun 2006. J Sports Sci Med. 2007, 6: 401-407.PubMed
21.
go back to reference Knechtle B, Rüst CA, Rosemann T, Lepers R: Age-related changes in 100-km ultra-marathon running performance. Age (Dordr). 2012, 34: 1033-1045. 10.1007/s11357-011-9290-9.CrossRef Knechtle B, Rüst CA, Rosemann T, Lepers R: Age-related changes in 100-km ultra-marathon running performance. Age (Dordr). 2012, 34: 1033-1045. 10.1007/s11357-011-9290-9.CrossRef
22.
go back to reference Knechtle B, Knechtle P, Rosemann T: Low prevalence of exercise-associated hyponatremia in male 100 km ultra-marathon runners in Switzerland. Eur J Appl Physiol. 2011, 111: 1007-1016.CrossRefPubMed Knechtle B, Knechtle P, Rosemann T: Low prevalence of exercise-associated hyponatremia in male 100 km ultra-marathon runners in Switzerland. Eur J Appl Physiol. 2011, 111: 1007-1016.CrossRefPubMed
23.
go back to reference Speedy DB, Noakes TD, Kimber NE, Rogers IR, Thompson JM, Boswell DR, Ross JJ, Campbell RG, Gallagher PG, Kuttner JA: Fluid balance during and after an Ironman triathlon. Clin J Sport Med. 2001, 11: 44-50. 10.1097/00042752-200101000-00008.CrossRefPubMed Speedy DB, Noakes TD, Kimber NE, Rogers IR, Thompson JM, Boswell DR, Ross JJ, Campbell RG, Gallagher PG, Kuttner JA: Fluid balance during and after an Ironman triathlon. Clin J Sport Med. 2001, 11: 44-50. 10.1097/00042752-200101000-00008.CrossRefPubMed
24.
go back to reference Lepers R: Analysis of Hawaii Ironman performance in elite triathletes from 1981 to 2007. Med Sci Sports Exerc. 2008, 40: 1828-1834. 10.1249/MSS.0b013e31817e91a4.CrossRefPubMed Lepers R: Analysis of Hawaii Ironman performance in elite triathletes from 1981 to 2007. Med Sci Sports Exerc. 2008, 40: 1828-1834. 10.1249/MSS.0b013e31817e91a4.CrossRefPubMed
25.
go back to reference Sharwood K, Collins M, Goedecke J, Wilson G, Noakes T: Weight changes, sodium levels, and performance in the South African Ironman Triathlon. Clin J Sport Med. 2002, 12: 391-399. 10.1097/00042752-200211000-00012.CrossRefPubMed Sharwood K, Collins M, Goedecke J, Wilson G, Noakes T: Weight changes, sodium levels, and performance in the South African Ironman Triathlon. Clin J Sport Med. 2002, 12: 391-399. 10.1097/00042752-200211000-00012.CrossRefPubMed
26.
go back to reference Becque MD, Katch VL, Moffatt RJ: Time course of skin-plus-fat compression in males and females. Hum Biol. 1986, 58: 33-42.PubMed Becque MD, Katch VL, Moffatt RJ: Time course of skin-plus-fat compression in males and females. Hum Biol. 1986, 58: 33-42.PubMed
27.
go back to reference Knechtle B, Joleska I, Wirth A, Knechtle P, Rosemann T, Senn O: Intra- and inter-judge reliabilities in measuring the skin-fold thicknesses of ultra-runners under field conditions. Percept Mot Skills. 2010, 111: 105-106. 10.2466/03.05.PMS.111.4.105-106.CrossRefPubMed Knechtle B, Joleska I, Wirth A, Knechtle P, Rosemann T, Senn O: Intra- and inter-judge reliabilities in measuring the skin-fold thicknesses of ultra-runners under field conditions. Percept Mot Skills. 2010, 111: 105-106. 10.2466/03.05.PMS.111.4.105-106.CrossRefPubMed
28.
go back to reference Stewart AD, Hannan WJ: Prediction of fat mass and fat-free mass in male athletes using dual X-ray absorbtiometry as the reference method. J Sports Sci. 2000, 18: 263-274. 10.1080/026404100365009.CrossRefPubMed Stewart AD, Hannan WJ: Prediction of fat mass and fat-free mass in male athletes using dual X-ray absorbtiometry as the reference method. J Sports Sci. 2000, 18: 263-274. 10.1080/026404100365009.CrossRefPubMed
29.
go back to reference Lee RC, Wang Z, Heo M, Ross R, Janssen I, Heymsfield SB: Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models. Am J Clin Nutr. 2000, 72: 796-803.PubMed Lee RC, Wang Z, Heo M, Ross R, Janssen I, Heymsfield SB: Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models. Am J Clin Nutr. 2000, 72: 796-803.PubMed
30.
go back to reference Steiner RW: Interpreting the fractional excretion of sodium. Am J Med. 1984, 77: 699-702. 10.1016/0002-9343(84)90368-1.CrossRefPubMed Steiner RW: Interpreting the fractional excretion of sodium. Am J Med. 1984, 77: 699-702. 10.1016/0002-9343(84)90368-1.CrossRefPubMed
31.
go back to reference Dole VP: Back diffusion of urea in the mammalian kidney. Am J Physiol. 1943, 139: 504-519. Dole VP: Back diffusion of urea in the mammalian kidney. Am J Physiol. 1943, 139: 504-519.
32.
go back to reference West ML, Marsden PA, Richardson RM, Zettle RM, Halperin ML: New clinical approach to evaluate disorders of potassium excretion. Miner Electrolyte Metab. 1986, 12: 234-238.PubMed West ML, Marsden PA, Richardson RM, Zettle RM, Halperin ML: New clinical approach to evaluate disorders of potassium excretion. Miner Electrolyte Metab. 1986, 12: 234-238.PubMed
33.
go back to reference Gault MH, Longerich LL, Harnett JD, Wesolowski C: Predicting glomerular function from adjusted serum creatinine (editorial). Nephron. 1992, 62: 249-256. 10.1159/000187054.CrossRefPubMed Gault MH, Longerich LL, Harnett JD, Wesolowski C: Predicting glomerular function from adjusted serum creatinine (editorial). Nephron. 1992, 62: 249-256. 10.1159/000187054.CrossRefPubMed
34.
go back to reference Strauss MB, Davies RK, Rosenbaum JD, Rossmeisl EC: Water diuresis produced during recumbency by the intravenous infusion of isotonic saline solution. J Clin Invest. 1951, 30: 862-868. 10.1172/JCI102501.CrossRefPubMed Strauss MB, Davies RK, Rosenbaum JD, Rossmeisl EC: Water diuresis produced during recumbency by the intravenous infusion of isotonic saline solution. J Clin Invest. 1951, 30: 862-868. 10.1172/JCI102501.CrossRefPubMed
35.
go back to reference Kirchhoff E: Online-Publication of the German Food Composition Table ‘Souci–Fachmann–Kraut’ on the Internet. J Food Comp Anal. 2002, 15: 465-472. 10.1006/jfca.2002.1091.CrossRef Kirchhoff E: Online-Publication of the German Food Composition Table ‘Souci–Fachmann–Kraut’ on the Internet. J Food Comp Anal. 2002, 15: 465-472. 10.1006/jfca.2002.1091.CrossRef
36.
go back to reference Knechtle B, Baumann B, Wirth A, Knechtle P, Rosemann T: Male Ironman triathletes lose skeletal muscle mass. Asia Pac J Clin Nutr. 2010, 19: 91-97.PubMed Knechtle B, Baumann B, Wirth A, Knechtle P, Rosemann T: Male Ironman triathletes lose skeletal muscle mass. Asia Pac J Clin Nutr. 2010, 19: 91-97.PubMed
37.
go back to reference Tam N, Nolte HW, Noakes TD: Changes in total body water content during running races of 21.1 km and 56 km in athletes drinking ad libitum. Clin J Sport Med. 2011, 21: 218-225. 10.1097/JSM.0b013e31820eb8d7.CrossRefPubMed Tam N, Nolte HW, Noakes TD: Changes in total body water content during running races of 21.1 km and 56 km in athletes drinking ad libitum. Clin J Sport Med. 2011, 21: 218-225. 10.1097/JSM.0b013e31820eb8d7.CrossRefPubMed
38.
go back to reference Noakes TD, Goodwin N, Rayner BL, Branken T, Taylor RK: Water intoxication: a possible complication during endurance exercise. Med Sci Sports Exerc. 1985, 17: 370-375.CrossRefPubMed Noakes TD, Goodwin N, Rayner BL, Branken T, Taylor RK: Water intoxication: a possible complication during endurance exercise. Med Sci Sports Exerc. 1985, 17: 370-375.CrossRefPubMed
39.
go back to reference Noakes TD, Sharwood K, Speedy D, Hew T, Reid S, Dugas J, Almond C, Wharam P, Weschler L: Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances. Proc Natl Acad Sci USA. 2005, 102: 18550-18555. 10.1073/pnas.0509096102.CrossRefPubMed Noakes TD, Sharwood K, Speedy D, Hew T, Reid S, Dugas J, Almond C, Wharam P, Weschler L: Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances. Proc Natl Acad Sci USA. 2005, 102: 18550-18555. 10.1073/pnas.0509096102.CrossRefPubMed
40.
go back to reference Speedy DB, Noakes TD, Rogers IR, Thompson JM, Campbell RG, Kuttner JA, Boswell DR, Wright S, Hamlin M: Hyponatremia in ultradistance triathletes. Med Sci Sports Exerc. 1999, 31: 809-815. 10.1097/00005768-199906000-00008.CrossRefPubMed Speedy DB, Noakes TD, Rogers IR, Thompson JM, Campbell RG, Kuttner JA, Boswell DR, Wright S, Hamlin M: Hyponatremia in ultradistance triathletes. Med Sci Sports Exerc. 1999, 31: 809-815. 10.1097/00005768-199906000-00008.CrossRefPubMed
41.
go back to reference Almond CS, Shin AY, Fortescue EB, Mannix RC, Wypij D, Binstadt BA, Duncan CN, Olson DP, Salerno AE, Newburger JW, Greenes DS: Hyponatremia among runners in the Boston Marathon. N Engl J Med. 2005, 352: 1550-1556. 10.1056/NEJMoa043901.CrossRefPubMed Almond CS, Shin AY, Fortescue EB, Mannix RC, Wypij D, Binstadt BA, Duncan CN, Olson DP, Salerno AE, Newburger JW, Greenes DS: Hyponatremia among runners in the Boston Marathon. N Engl J Med. 2005, 352: 1550-1556. 10.1056/NEJMoa043901.CrossRefPubMed
42.
go back to reference 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, 13: 41-47. 10.1097/00042752-200301000-00008.CrossRefPubMed 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, 13: 41-47. 10.1097/00042752-200301000-00008.CrossRefPubMed
43.
go back to reference Hew-Butler T, Verbalis JG, Noakes TD: Updated fluid recommendation: Position Statement from the International Marathon Medical Directors Association (IMMDA). Clin J Sport Med. 2006, 16: 283-292. 10.1097/00042752-200607000-00001.CrossRefPubMed Hew-Butler T, Verbalis JG, Noakes TD: Updated fluid recommendation: Position Statement from the International Marathon Medical Directors Association (IMMDA). Clin J Sport Med. 2006, 16: 283-292. 10.1097/00042752-200607000-00001.CrossRefPubMed
44.
go back to reference 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. 10.1136/bjsm.2005.022418.CrossRefPubMed 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. 10.1136/bjsm.2005.022418.CrossRefPubMed
45.
go back to reference Speedy DB, Thompson JM, Rodgers I, Collins M, Sharwood K, Noakes TD: Oral salt supplementation during ultradistance exercise. Clin J Sport Med. 2002, 12: 279-284. 10.1097/00042752-200209000-00004.CrossRefPubMed Speedy DB, Thompson JM, Rodgers I, Collins M, Sharwood K, Noakes TD: Oral salt supplementation during ultradistance exercise. Clin J Sport Med. 2002, 12: 279-284. 10.1097/00042752-200209000-00004.CrossRefPubMed
46.
go back to reference Noakes TD: Changes in body mass alone explain almost all of the variance in the serum sodium concentrations during prolonged exercise. Has commercial influence impeded scientific endeavour?. Br J Sports Med. 2011, 45: 475-477. 10.1136/bjsm.2010.075697.CrossRefPubMed Noakes TD: Changes in body mass alone explain almost all of the variance in the serum sodium concentrations during prolonged exercise. Has commercial influence impeded scientific endeavour?. Br J Sports Med. 2011, 45: 475-477. 10.1136/bjsm.2010.075697.CrossRefPubMed
47.
go back to reference Kavouras SA: Assessing hydration status. Curr Opin Clin Nutr Metab Care. 2002, 5: 519-524. 10.1097/00075197-200209000-00010.CrossRefPubMed Kavouras SA: Assessing hydration status. Curr Opin Clin Nutr Metab Care. 2002, 5: 519-524. 10.1097/00075197-200209000-00010.CrossRefPubMed
48.
go back to reference Shireffs SM: Markers of hydration status. Eur J Clin Nutr. 2003, 57: S6-S9.CrossRef Shireffs SM: Markers of hydration status. Eur J Clin Nutr. 2003, 57: S6-S9.CrossRef
49.
go back to reference Stellingwerff T, Boon H, Jonkers RA, Senden JM, Spriet LL, Koopman R, van Loon LJ: Significant intramyocellular lipid use during prolonged cycling in endurance-trained males as assessed by three different methodologies. Am J Physiol. 2007, 292: E1715-E1723. Stellingwerff T, Boon H, Jonkers RA, Senden JM, Spriet LL, Koopman R, van Loon LJ: Significant intramyocellular lipid use during prolonged cycling in endurance-trained males as assessed by three different methodologies. Am J Physiol. 2007, 292: E1715-E1723.
50.
go back to reference Dancaster CP, Duckworth WC, Roper CJ: Nephropathy in marathon runners. S Afr Med J. 1969, 43: 758-759.PubMed Dancaster CP, Duckworth WC, Roper CJ: Nephropathy in marathon runners. S Afr Med J. 1969, 43: 758-759.PubMed
51.
go back to reference Irving RA, Noakes TD, Raine RI: Van Zyl Smit R: Transient oliguria with renal tubular dysfunction after a 90 km run. Med Sci Sports Exerc. 1990, 22: 756-761.CrossRefPubMed Irving RA, Noakes TD, Raine RI: Van Zyl Smit R: Transient oliguria with renal tubular dysfunction after a 90 km run. Med Sci Sports Exerc. 1990, 22: 756-761.CrossRefPubMed
52.
go back to reference Eisenbeiss C, Welzel J, Eichler W, Klotz K: Influence of body water distribution on skin thickness: measurements using high-frequency ultrasound. Br J Dermatol. 2001, 144: 947-951. 10.1046/j.1365-2133.2001.04180.x.CrossRefPubMed Eisenbeiss C, Welzel J, Eichler W, Klotz K: Influence of body water distribution on skin thickness: measurements using high-frequency ultrasound. Br J Dermatol. 2001, 144: 947-951. 10.1046/j.1365-2133.2001.04180.x.CrossRefPubMed
53.
go back to reference Irving RA, Noakes TD, van Zyl Smit R: Metabolic and renal changes in two athletes during a world 24 hour relay record performance. Br J Sports Med. 1989, 23: 227-232. 10.1136/bjsm.23.4.227.CrossRefPubMed Irving RA, Noakes TD, van Zyl Smit R: Metabolic and renal changes in two athletes during a world 24 hour relay record performance. Br J Sports Med. 1989, 23: 227-232. 10.1136/bjsm.23.4.227.CrossRefPubMed
54.
go back to reference Espinel CH: The FENa-Test. Use in differential diagnosis of acute renal failure. JAMA. 1976, 236: 579-581. 10.1001/jama.1976.03270060029022.CrossRefPubMed Espinel CH: The FENa-Test. Use in differential diagnosis of acute renal failure. JAMA. 1976, 236: 579-581. 10.1001/jama.1976.03270060029022.CrossRefPubMed
55.
go back to reference Ludwig M, Vetter H: Diagnosis and differential diagnosis of swollen leg. Schweiz Rundsch Med Prax. 1989, 78: 987-992.PubMed Ludwig M, Vetter H: Diagnosis and differential diagnosis of swollen leg. Schweiz Rundsch Med Prax. 1989, 78: 987-992.PubMed
56.
go back to reference Ruschhaupt WF, Graor RA: Evaluation of the patient with leg edema. Postgrad Med. 1985, 78: 132-139.PubMed Ruschhaupt WF, Graor RA: Evaluation of the patient with leg edema. Postgrad Med. 1985, 78: 132-139.PubMed
57.
59.
go back to reference Friedli S, Mahler F: Venous and lymphatic reasons for edema--the swollen leg from the angiologist's point of view. Ther Umsch. 2004, 61: 643-647. 10.1024/0040-5930.61.11.643.CrossRefPubMed Friedli S, Mahler F: Venous and lymphatic reasons for edema--the swollen leg from the angiologist's point of view. Ther Umsch. 2004, 61: 643-647. 10.1024/0040-5930.61.11.643.CrossRefPubMed
60.
go back to reference Cejka C, Knechtle B, Knechtle P, Rüst CA, Rosemann T: An increased fluid intake leads to feet swelling in 100-km ultra-marathoners - an observational field study. J Int Soc Sports Nutr. 2012, 9: 11-10.1186/1550-2783-9-11.CrossRefPubMed Cejka C, Knechtle B, Knechtle P, Rüst CA, Rosemann T: An increased fluid intake leads to feet swelling in 100-km ultra-marathoners - an observational field study. J Int Soc Sports Nutr. 2012, 9: 11-10.1186/1550-2783-9-11.CrossRefPubMed
61.
go back to reference Caton JR, Molé PA, Adams WC, Heustis DS: Body composition analysis by bioelectrical impedance: effect of skin temperature. Med Sci Sports Exerc. 1998, 20: 489-491. Caton JR, Molé PA, Adams WC, Heustis DS: Body composition analysis by bioelectrical impedance: effect of skin temperature. Med Sci Sports Exerc. 1998, 20: 489-491.
62.
go back to reference Knechtle B, Salas Fraire O, Andonie JL, Kohler G: A multi-stage ultra- endurance triathlon leads to a decrease of body fat but not of skeletal muscle mass-The World Challenge Deca Iron 2006. Br J Sports Med. 2008, 42: 121-125.CrossRefPubMed Knechtle B, Salas Fraire O, Andonie JL, Kohler G: A multi-stage ultra- endurance triathlon leads to a decrease of body fat but not of skeletal muscle mass-The World Challenge Deca Iron 2006. Br J Sports Med. 2008, 42: 121-125.CrossRefPubMed
63.
go back to reference O’Brien C, Young AJ, Sawka MN: Bioelectrical impedance to estimate changes in hydration status. Int J Sports Med. 2002, 23: 361-366. 10.1055/s-2002-33145.CrossRefPubMed O’Brien C, Young AJ, Sawka MN: Bioelectrical impedance to estimate changes in hydration status. Int J Sports Med. 2002, 23: 361-366. 10.1055/s-2002-33145.CrossRefPubMed
64.
go back to reference Berneis K, Keller U: Bioelectrical impedance analysis during acute changes of extracellular osmolality in man. Clin Nutr. 2000, 19: 361-366. 10.1054/clnu.2000.0133.CrossRefPubMed Berneis K, Keller U: Bioelectrical impedance analysis during acute changes of extracellular osmolality in man. Clin Nutr. 2000, 19: 361-366. 10.1054/clnu.2000.0133.CrossRefPubMed
65.
go back to reference Pialoux V, Mischler I, Mounier R, Gachon P, Ritz P, Coudert J, Fellmann N: Effect of equilibrated hydration changes on total body water estimates by bioelectrical impedance analysis. Brit J Nutr. 2004, 91: 153-159. 10.1079/BJN20031031.CrossRefPubMed Pialoux V, Mischler I, Mounier R, Gachon P, Ritz P, Coudert J, Fellmann N: Effect of equilibrated hydration changes on total body water estimates by bioelectrical impedance analysis. Brit J Nutr. 2004, 91: 153-159. 10.1079/BJN20031031.CrossRefPubMed
66.
go back to reference Knechtle B, Duff B, Schulze I, Kohler G: The effects of running 1,200 km within 17 days on body composition in a female ultrarunner-Deutschlandlauf 2007. Res Sports Med. 2008, 16: 167-188.CrossRefPubMed Knechtle B, Duff B, Schulze I, Kohler G: The effects of running 1,200 km within 17 days on body composition in a female ultrarunner-Deutschlandlauf 2007. Res Sports Med. 2008, 16: 167-188.CrossRefPubMed
67.
go back to reference Breyer MD, Jacobson HR, Hebert RL: Cellular mechanisms of prostaglandin E2 and vasopressin interactions in the collecting duct. Kidney Int. 1990, 38: 618-626. 10.1038/ki.1990.251.CrossRefPubMed Breyer MD, Jacobson HR, Hebert RL: Cellular mechanisms of prostaglandin E2 and vasopressin interactions in the collecting duct. Kidney Int. 1990, 38: 618-626. 10.1038/ki.1990.251.CrossRefPubMed
68.
go back to reference Hebert RL, Jacobson HR, Breyer MD: PGE2 inhibits AVP induces water flow in cortical collecting ducts by protein kinase C activation. Am J Physiol. 1990, 259: F318-F324.PubMed Hebert RL, Jacobson HR, Breyer MD: PGE2 inhibits AVP induces water flow in cortical collecting ducts by protein kinase C activation. Am J Physiol. 1990, 259: F318-F324.PubMed
69.
go back to reference Patrono C, Dunn MJ: The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int. 1987, 32: 1-10. 10.1038/ki.1987.164.CrossRefPubMed Patrono C, Dunn MJ: The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int. 1987, 32: 1-10. 10.1038/ki.1987.164.CrossRefPubMed
70.
go back to reference Kemmler W, von Stengel S, Köckritz C, Mayhew J, Wassermann A, Zapf J: Effect of compression stockings on running performance in men runners. J Strength Cond Res. 2009, 23: 101-105. 10.1519/JSC.0b013e31818eaef3.CrossRefPubMed Kemmler W, von Stengel S, Köckritz C, Mayhew J, Wassermann A, Zapf J: Effect of compression stockings on running performance in men runners. J Strength Cond Res. 2009, 23: 101-105. 10.1519/JSC.0b013e31818eaef3.CrossRefPubMed
71.
go back to reference Knechtle B, Knechtle P, Rüst CA, Gnädinger M, Imoberdorf R, Kohler G, Rosemann T, Ballmer P: Regulation of Electrolyte and Fluid Metabolism in Multi-stage Ultra-Marathoners. Horm Metab Res. 2012, Epub ahead of print. Knechtle B, Knechtle P, Rüst CA, Gnädinger M, Imoberdorf R, Kohler G, Rosemann T, Ballmer P: Regulation of Electrolyte and Fluid Metabolism in Multi-stage Ultra-Marathoners. Horm Metab Res. 2012, Epub ahead of print.
72.
go back to reference Rüst CA, Knechtle B, Knechtle P, Rosemann T: Higher prevalence of exercise-associated hyponatremia in Triple Iron ultra-triathletes than reported for Ironman triathletes. Chin J Physiol. 2012, 55: 147-155.CrossRefPubMed Rüst CA, Knechtle B, Knechtle P, Rosemann T: Higher prevalence of exercise-associated hyponatremia in Triple Iron ultra-triathletes than reported for Ironman triathletes. Chin J Physiol. 2012, 55: 147-155.CrossRefPubMed
73.
go back to reference Butner KL, Creamer KW, Nickols-Richardson SM, Clark SF, Ramp WK, Herbert WG: Fat and muscle indices assessed by pQCT: relationships with physical activity and type 2 diabetes risk. J Clin Densitom. 2012, Epub ahead of print. Butner KL, Creamer KW, Nickols-Richardson SM, Clark SF, Ramp WK, Herbert WG: Fat and muscle indices assessed by pQCT: relationships with physical activity and type 2 diabetes risk. J Clin Densitom. 2012, Epub ahead of print.
Metadata
Title
Ad libitum fluid intake leads to no leg swelling in male Ironman triathletes – an observational field study
Authors
Michael Meyer
Beat Knechtle
Jolanda Bürge
Patrizia Knechtle
Claudia Mrazek
Andrea Wirth
Birte Ellenrieder
Christoph Alexander Rüst
Thomas Rosemann
Publication date
01-12-2012
Publisher
BioMed Central
DOI
https://doi.org/10.1186/1550-2783-9-40

Other articles of this Issue 1/2012

Journal of the International Society of Sports Nutrition 1/2012 Go to the issue