Wednesday, November 23, 2022

The Salt in Sports Drinks May Not Be As Crucial As You Think

Replacing lost salt is a pillar of sports nutrition, but new research suggests more isn’t always better
Alex HutchinsonNov 4, 2022
A detail shot of a volunteer as he hads a Gatorade refreshment cup to a runner as he passes through a water station in the town of Natick during the Boston marathon

In the mid-1960s, a researcher at the University of Florida named Robert Cade went to a bank and borrowed $500 to buy sugar and salt. The homemade drink he’d devised for the university’s football team, dubbed Cade’s Cola—or Gatorade—was attracting widespread attention, and he wanted to mix a big batch of it to sell. The sugar provided crucial fourth-quarter energy for the players, and the salt—well, scientists and athletes are still debating what role the salt in sports drinks plays in athletic performance.

The question lurks in the background of a new study published in the European Journal of Sport Science, by sports nutrition researcher Alan McCubbin of Monash University in Australia. The study uses a mathematical model to determine exactly how much sodium is required during exercise of varying intensities and durations, depending on how much a person sweats, how salty that sweat is, how much they drink, and other factors. The answers depend on the assumptions we make about why athletes need salt. But in the vast majority of real-world situations, McCubbin concludes, we don’t need to worry about it.

There’s no doubt that sodium—the key electrolyte in salt—has a number of crucial responsibilities in the body. It helps muscles contract, conducts nerve signals, and keeps internal fluid levels balanced. It’s also true that we lose sodium through sweat. In the 1930s, after at least 13 workers died of heat exhaustion during the first year of construction on the Hoover Dam, in Nevada, tests conducted by Harvard physiologist D. B. Dill revealed that the workers were sweating out large quantities of sodium. The solution: in the dining hall, alongside a sign that read, DRINK PLENTY OF WATER, Dill’s team added, AND PUT PLENTY OF SALT ON YOUR FOOD.

But taking in salt during exercise is another matter. There are three principal reasons you might want to do this. The most frequently cited is to ward off muscle cramps, but scientific evidence largely contradicts this idea. Studies involving runners and triathletes have found no significant difference in sodium levels between those who experience cramping during exercise and those who don’t, and deliberately lowering those levels appears to have no effect one way or the other. There are many reasons why we cramp, and sodium may be involved in some of them. But when it comes to exercise-related cramping, increasing our salt consumption doesn’t appear to be the solution.

The second reason to boost salt intake while exercising is to avoid hyponatremia (literally, low blood sodium)—a dangerous and occasionally fatal condition. On paper, drinking something salty would seem like a good way to ensure healthy sodium levels. But sports drinks are less salty than blood, so the more you chug, the more diluted your blood becomes. As a result, the main risk factor for hyponatremia is actually taking in too many fluids—be it water or sports drinks—not too little salt. That’s why current guidelines advise drinking when thirsty rather than following an aggressive hydration plan.

The third reason is the one McCubbin considers legit: regulating fluid concentrations. The human body is replete with fluids—in the blood, in the cells, and in the spaces between cells. Your body monitors sodium levels to decide how to allocate fluid stores among these three areas. That means you’ve got a buffer when you start exerting yourself; even though you’re sweating, water from other localities can shift into your blood plasma to maintain sodium concentration. However, if prolonged sweating depletes sodium levels too much and you’re only drinking water, the opposite happens: fluid shifts out of your plasma to keep concentrations from dropping elsewhere, leaving you with lower blood volume to ferry oxygen to muscles and dissipate heat. That, in theory at least, is a problem.

The relevant question, then, isn’t how much sodium you need in order to replace what’s lost to sweat. It’s how much you need to keep your blood concentration from dropping, taking into account that your body is moving fluid around internally. Crucially, the answer doesn’t just depend on how much sodium you sweat out; it also depends on how much fluid you take in.

“There’s a big difference between losing four liters of salty sweat in a marathon and replacing two liters of that with plain water, and losing 20 liters in a 100-miler and replacing it with 18 liters of plain water,” McCubbin explains. In both cases, you’ve lost the same quantity of fluid: two liters, or 4.4 pounds of body weight. But it’s really the turnover that matters. In the latter instance you’ve sweated out far more sodium, and are therefore more likely to exceed your body’s ability to compensate for the loss.

For his study, McCubbin used equations developed by kidney specialists to calculate blood-sodium concentration. Among soccer players and marathoners, he concluded, making a deliberate effort to replace sodium beyond what taste preferences dictate is “unnecessary in all realistic scenarios.” In 100-mile ultramarathons, where longer duration results in far greater salt loss, the picture is more nuanced. For runners whose sweat is saltier than average and who aim to drink aggressively enough to limit fluid losses to 2 percent of their starting weight, drinking water alone would leave them short on sodium. (These ultras are so taxing that runners also lose weight from the carbohydrate and fat reserves they burn, so they may be 3 to 5 percent lighter on the scale by the time their fluid losses hit 2 percent. That’s about what current hydration advice for ultramarathoners recommends.)

The sodium content of your sweat can be roughly inferred from the amount of dried salt left on your clothes and skin after a workout, or it can be determined with greater accuracy through testing offered by companies like Precision Hydration. But even if you’re a salty sweater, mainlining sodium tablets is a risky proposition. Overdoing salt intake can make you thirstier, increasing the chances that you’ll drink too much and, paradoxically, perhaps even putting you at risk of hyponatremia, according to Martin Hoffman, an ultra-endurance researcher at the University of California at Davis. Instead, Hoffman recommends taking in salt with food as dictated by your cravings, rather than following a predetermined salt-intake regimen. “It’s realistic to say don’t worry about it or don’t listen to the so-called experts who have a product to sell as long as one is attuned to one’s body,” he says.

In fact, sodium needs during a 100-miler may be even lower than McCubbin’s calculations suggest, according to Hoffman. There’s some evidence that the body contains additional sodium that gets released into circulation with prolonged sweating, although the idea is controversial among scientists.

Both Hoffman and McCubbin agree that a small minority of people with unusually salty sweat might run into problems in a multi-hour event like an ultra. For those individuals, sweat testing to determine exactly how much salt they’re losing might have value. At a minimum, they’ll benefit from a deliberate plan to restock lost sodium through food, sports drinks, and perhaps even salt tablets. For the rest of us, McCubbin’s advice mirrors the shift in thinking about hydrationover the past few decades, from the hard-nosed “Drink to replace what you lose” to the more subjective “Drink when you’re thirsty.” When it comes to salt, McCubbin says, the new rule is: “Season to taste.”

Sunday, November 6, 2022

When Exercise Does More Harm than Good


Time, the Weekly Magazine

FEBRUARY 2, 2015 3:30 PM EST

Americans as a whole don’t exercise enough—at least that’s what the latest studies show—and so the message is clear: get more active, take walks, Let’s Move! Basically anything is better than sitting on the couch. But how much exercise is enough? That’s a hotly debated question for which experts still don’t have a satisfactory answer. But given that most of us are starting from a sedentary position, the assumption has long been the more the better.

But in a report published Monday in the Journal of the American College of Cardiology researchers from Denmark say that people who push their bodies too hard may essentially undo the benefit of exercise. Those who ran at a fast pace more than four hours a week for more than three days a week had about the same risk of dying during the study’s 12-year follow up as those who were sedentary and hardly exercised at all. The link held even after the researchers accounted for potentially confounding factors such as age, sex, whether the participants had a history of heart disease or diabetes, or whether they smoked and drank alcohol.

In fact, those with the lowest risk of dying during the study period were people who ran less than three times a week for one to 2.4 hours, at a slow to moderate pace. Even people who ran slightly more, for 2.5 hours to four hours a week at an average pace less than three times a week, showed slightly higher mortality risk, at 66%, something that came as a surprise to the authors.


What Marott and his team found was that both too little running and too much running are linked to higher rates of death. The most intense runners ended up with a risk of dying that was similar to that of those who opted to stay on the couch. Somewhere in between is the Goldilocks amount that’s just right to maintain heart health, burn off excess calories and keep blood sugar levels under control. And according to his results, that sweet spot is closer to the ‘less’ side of the curve than the ‘more’ side.

That dovetails with the mounting research that so-called micro-workouts—high intensity but brief workouts that could be as short at 1 minute, according to another recent paper—may be better for the body than long and continuous workouts.

That still means that some exercise is better than no exercise, but scientists may be getting more sophisticated about understanding that more isn’t always better, and that there may be a tipping point at which the harms of running start to outweighed its benefits.

Those negative effects might include things like changes in the structure and function of the heart and its vessels; previous studies showed that marathoners and long distance cyclists, for example, tend to be at higher risk of developing abnormal heart rhythms, and may be more vulnerable to enlarged hearts, which are less efficient at pumping blood and delivering oxygen and removing waste than normal-sized organs.

Marott acknowledges that it’s also possible that some other behaviors or factors common to avid runners, such as their exposure to the sun, which can increase their risk of skin cancer, might be explaining their higher risk of dying during the study. Other studies will have to investigate whether that’s the case, but in the meantime, Marott says “if you want to do something good for yourself, you don’t have to be extreme. Jogging one to four hours a week for no more than three days a week at a slow to moderate pace is actually achievable. And that’s a positive take-home message.”

Thursday, November 3, 2022

The Two Blunders That Caused the Ukraine War

Wall Street Journal

Robert Service, a leading historian of Russia, says Moscow will win the war but will lose the peace and fail to subjugate Ukraine. How Putin could be deposed.

By Tunku Varadarajan

March 4, 2022 1:07 pm ET

The Russian invasion of Ukraine resulted from two immense strategic blunders, Robert Service says. The first came on Nov. 10, when the U.S. and Ukraine signed a Charter on Strategic Partnership, which asserted America’s support for Kyiv’s right to pursue membership in the North Atlantic Treaty Organization. The pact made it likelier than ever that Ukraine would eventually join NATO—an intolerable prospect for Vladimir Putin. “It was the last straw,” Mr. Service says. Preparations immediately began for Russia’s so-called special military operation in Ukraine.

`Mr. Service, 74, is a veteran historian of Russia, a professor emeritus at St. Antony’s College, Oxford, and a fellow at Stanford’s Hoover Institution. He has written biographies of Lenin, Stalin, and Trotsky. The last work, published in 2009, attracted the ire of die-hard Trotskyites worldwide for saying that their hero shared many basic ideas with Lenin and Stalin on the “one-party, one ideology terror state.” Mr. Service says they still “mess around” his Wikipedia entry.

The November agreement added heft to looser assurances Ukraine received at a NATO summit five months earlier that membership would be open to the country if it met the alliance’s criteria. Mr. Service characterizes these moves as “shambolic mismanagement” by the West, which offered Ukraine encouragement on the NATO question but gave no apparent thought to how such a tectonic move away from Moscow would go down with Mr. Putin. “Nothing was done to prepare the Ukrainians for the kind of negative response that they would get.”

After all, Mr. Service says, Ukraine is “one of the hot spots in the mental universe of Vladimir Putin, and you don’t wander into it without a clear idea of what you’re going to do next.” The West has known that since at least 2007, when the Russian ruler made a speech at the Munich Conference on Security Policy that was, in Mr. Service’s words, “a rage against Ukraine ever joining NATO.” He was about to step down from the Russian presidency (to become prime minister for four years), “so it was his last lion’s roar in the jungle.” When he returned as president in 2012, he made it clear again that “the Ukraine-NATO question wasn’t negotiable.”

In July 2021 he wrote an essay that foretold the invasion. Mr. Service sums it up as saying, “more or less, that Ukrainians and Russians are one people.” Mr. Putin had said so many times before, “but not as angrily and punchily—and emotionally.”

It rankles Mr. Putin that Ukraine would seek to join the West—and not merely because he wants it as a satellite state. He also “can’t afford to allow life to a neighboring Slav state which has even a smidgen of democratic development. His Russian people might get dangerous ideas.”

As a result of the invasion, which began on Feb. 24, “the U.S. has started to get its act together,” Mr. Service says. “But I don’t think American diplomacy covered itself in glory in 2021.”

The second strategic error was Mr. Putin’s underestimation of his rivals. “He despises the West and what he sees as Western decadence,” Mr. Service says. “He had come to believe that the West was a shambles, both politically and culturally.” He also thought that the leaders of the West were “of poor quality, and inexperienced, in comparison with himself. After all, he’s been in power 20 years.”

In Mr. Putin’s cocksure reckoning, the invasion was going to be “a pushover—not just in regard to Ukraine, but in regard to the West.” He’d spent four years “running rings around Donald Trump, ” and he thought the retirement of German Chancellor Angela Merkel left the West rudderless. That set the scene for the “surprise he got when he invaded Ukraine when he found that he’d inadvertently united the West—that what he’d done was the very opposite of what he wanted.” Mr. Service calls Mr. Putin “reckless and mediocre” and scoffs at the notion that he is “some sort of genius.” What kind of Russian leader, he asks, “makes it impossible for a German leader not to build up Germany’s armaments”?

Mr. Putin evidently “hoped there wouldn’t have to be a war” because the massing of troops on the border would lead to the collapse of the Ukrainian government. He underestimated Volodymyr Zelensky, whom he’d met in Paris in December 2019, six months after the Ukrainian president took office. Mr. Putin had “done his usual brutal discussion performance with him. Zelensky came out of these talks obviously shaken.”

Mr. Service says the key to understanding Mr. Putin is his adamant belief that Russia is “a great global power” and that the Russian sphere of influence should extend to as many of the former Soviet republics as possible: “There’s no state that’s more important to him than Ukraine.”

The historian describes the Russian ruler as “not a communist but an anticommunist.” In Mr. Service’s telling, Mr. Putin regards the Soviet period as “a rupture” with the path to greatness that Russia should have taken. “Putin believes in Eternal Russia” and regards Lenin with “ridicule and detestation” for stunting Russia’s expansion. While Mr. Putin may say “occasionally pleasant things about Stalin, he has never said anything positive about Lenin.”

In Mr. Putin’s view, according to Mr. Service, Lenin committed a primordial sin in 1922 when the Soviet Constitution set up a federation of republics with their own boundaries within the Soviet Union. “This made possible the breakup of the U.S.S.R. into separate independent states in 1991,” Mr. Service says. Mr. Putin, like Stalin—who fell out with Lenin over these constitutional arrangements—would have liked all these republics to have been merged into a Greater Russia, ruled from Moscow.

“Putin despises democracy,” Mr. Service says. “He believes in the right of the leadership to impose the authority of the state on society.” In the Russian president’s view, this is good for citizens because it brings stability and predictability into their lives. He also believes in the importance of the secret police as an adjunct of government. In this, Mr. Service points out, many of his methods are “reminiscent of the Soviet period,” even if his ideology isn’t.

Mr. Putin “sees himself messianically,” Mr. Service says—as a leader come to deliver Russia to its destiny. He runs his government like “a court, though the czars were much more polite to their ministers.” Unless they go into political opposition, he doesn’t get rid of people who don’t share his vision. Instead, he “bats them down, and overawes them, treating them like schoolboys.” He “peppers them with questions” to keep them on their toes. He was a senior officer in the KGB, and the KGB is still in his soul. Rebranded as the FSB, “it’s the one agency from the old Soviet Union that has survived.”

As the Russian invasion continues into its second week, Mr. Service is pessimistic, certain that we’re heading into a prolonged war that will end in the subjugation of Ukraine. “He’ll win the war,” Mr. Service says, “by flattening Ukraine. By devastating a brother people, he could win the war. But he won’t win the peace. The task of tranquilizing the Ukrainians is beyond the Russians. There’s too much bile that’s been let loose in the stomach of Ukraine.”

Looking to history for analogies, he rejects Czechoslovakia in 1968, preferring instead the example of Hungary in 1956, when Soviet tanks rolled into Budapest to quell a major uprising. “When the Soviets suppressed the Hungarian Revolution, they had to pay for it economically,” Mr. Service says. “They had to subsidize Hungary with oil and gas.” Moscow bore a huge economic burden for “the retention of Hungary within its political orbit, and that would be the case with Ukraine. And they’d be hated at the same time—hated.” Not to mention taking on the weight of appeasing a conquered people at a time of impoverishment in Russia itself.

“Putin’s got to be removed from power,” Mr. Service says. That is the only way to end Ukraine’s torment. But how?

It could happen in two ways. The first is “a palace coup,” which at the moment “looks very, very unlikely” but could become plausible. The second is a mass uprising, “a tremendous surge in street demonstrations as a result of the economic hardship” imposed by the war and Western sanctions.

For a palace coup to succeed, there would need to be palpable disaffection in the Russian establishment. Mr. Service notes that the Russian Orthodox Church hasn’t yet condemned the war, nor has the Academy of Sciences. “By and large, the establishment has been quiescent.” But the “personal and collective interests” of the ruling elite are at stake. Not only will sanctions stop them from traveling to the French Riviera or sending their sons to England’s Eton College; they’ll have to line up behind “a really reckless line of policy, which will require Russia to patrol the biggest state in Europe, now full of angry, vengeful people.”

Reaching for the history books again, he cites the case of Lavrentiy Beria, Stalin’s all-powerful state security chief, who was almost certain to succeed the latter on his death in 1953. But the Presidium of the Supreme Soviet, as the Politburo was known at the time, got together with Nikita Khrushchev and decided that they “weren’t safe with Beria.” With the help of the army, they arrested, tried and executed him. “The thing that makes me think about this,” says Mr. Service, “is that the Presidium at the time seemed to be working under the impetus of Beria’s various initiatives quite peacefully.” His end came as a surprise to the world—and undoubtedly to Beria himself.

“So it’s quite possible,” Mr. Service continues, “that the apparently overawed associates of Putin in the Kremlin could decide that the Russian national interest and their collective interest will best be served by getting rid of Putin.” Yet Mr. Putin is surely aware of the history of Beria and is accordingly prepared: “He’s very elusive and very, very edgy. I should imagine his security orders are quite severe.”

The longer the war goes on, the more likely it is that Russia will see protest movements that are hard to contain, Mr. Service, says. “Especially if the police themselves have elements in their ranks who sympathize with the people they’re meant to be suppressing.”

There have been frequent uprisings in Russian history, and Mr. Service lists them. “In 1905, they nearly led to revolution. In February 1917, they did.” There were also “very, very powerful” street demonstrations in the early 1930s that shook Stalin; disturbances in the labor camps in the late 1940s, and also at Stalin’s death. “There were whole cities that erupted against the Soviet order in 1962, because of high meat prices, and there were strikes in 1989 among the coal miners, which destabilized Soviet politics.” And in 1991 an attempted coup against Mikhail Gorbachev prompted a demonstration outside Parliament, where future Russian President Boris Yeltsin famously faced down a Soviet tank.

He acknowledges that only twice did opponents succeed in toppling the political establishment, but he says that “if there’s a combination of political disorder on the streets and political unease in the ruling group,” as in 1917 and 1991, these factors could converge to powerful effect: “This is a distant possibility at the moment, but it can’t be ruled out.”

Mr. Service is certain, however, that the Russians will find conquered Ukrainians as difficult to control as free ones. “The Ukrainians have become more nationally conscious over the 20th century, and they’re a proud people who’ve seen what happened to them when they were subjugated by the U.S.S.R.” It is inconceivable that they will accept subjugation again. “They had it in the early 1930s when millions died under Stalin’s famines. They had it again in the late 1940s, after the war ended. I don’t think they’re going to let history repeat itself.”

The invasion of Ukraine, Mr. Service says, is not a tragedy for Ukraine alone. It’s a tragedy for Russia. “Russian people don’t deserve a ruler like Putin. They’ve not had very much luck with their rulers in the last 150 years. In fact, they’ve had appalling luck.”

Mr. Varadarajan, a Journal contributor, is a fellow at the American Enterprise Institute and at New York University Law School’s Classical Liberal Institute.