Let me start with a quiz:
Tom, Dick, and Harry are about to start running a marathon. They each weigh the same. The weather is hot, but humidity is low. Tom expects to finish the marathon in 2.5 hours, during which he will ingest nothing. Dick expects to finish in 5 hours, is pre-hydrated, and will take water at every aid station. Harry expects to finish in 6 hours, is pre-hydrated, and will take sports drink at every aid station.
Which of these is/are most/more likely to report to the medical tent? Answer: Dick and Harry.
Tim Noakes began his research career at about the same time marathon organizers, coaches, and others began advising runners to pre-hydrate, and stay ahead of thirst during marathons and other endurance events. As a researcher, Noakes, perpetuated this. But, some of the people who followed this advice were getting seriously sick. Noakes took a closer look at the studies, and discovered authors of key study in 1969 had made a classic error. The result of this and other research errors is that endurance athletes have been given bad advice -- advice that contributes to endurance athletes' need for medical attention and even fatalities.
For the last 30 years, Noakes has been studying how body temperature, water, and electrolytes are used or regulated in endurance sports, both in doing his own research and evaluating the research of others. In this book, he is critical of the research that generated the advice to "drink ahead of thirst" or advice that endurance athletes should take drinks that replace electrolytes. But, he claims research that advises endurance athletes to drink according to their thirst is well supported. By trying to stay ahead of thirst, an endurance athlete can drink enough to dilute electrolyte concentration, leading to a condition called exercise-associated hyponatremia.
Marathoners have been becoming more aware of the dangers of exercise-associated hyponatremia. However, there is still some bad advice out there. The sports drink industry would have us believe the electrolytes in their products can protect us from hyponatremia. Noakes argues it won't. To make matters worse, there is still confusion about symptoms of dehydration, heatstroke, and hyponatremia. Many athletes think they are dehydrated or approaching heat illness when they are actually overhydrated. Some of those in the medical tent might also be lacking in knowledge. This can lead to incorrect treatment.
Noakes wrote this book to help us get pass the bad advice, and show why it isn't supported by good science. Noakes wrote this book to help prevent more deaths.
After 27 drafts, Noakes submitted nearly 1,300 pages with a poor tone. With advice from an editor, Noakes got the book down to less than 450 pages, and improved the tone. But, some of the original still shows through: He occasionally seems to mock other research, and he can be repetitious, sometimes trying to drive home a point he had covered earlier. Sometimes his mocking can be funny, but I was usually a bit annoyed. This book is somewhere between a technical book, written for other researches, and the layman. I'm one of the layman readers, and I'm not qualified to read and evaluate the numerous studies he cites.
Noakes likes the philosophy of science of Karl Popper. Yet, in "Waterlogged," he sometimes writes that those who did research with conclusions that agree with his "proved" something. He also quotes someone as saying "The plural of 'anecdote' is not 'scientific data'," but this book has many anecdotes. Frankly however, even though anecdotes lack scientific standing, including runners' experiences makes the book more interesting to a lay reader.
If I were not interested in the subject, I would rate this book 3 stars, in part for being longer than it could have been. But, I am a marathoner, and a slow one at that. So, this really matters to me. For marathoners, triathletes, and others who participate, or are training to participate in athletic events which could last for hours, and for coaches, trainers and others who advise these athletes, this book is a "must read." Because of the importance to us, I give it 5 stars.
