The primary objective for replacing body fluid loss during exercise is to maintain normal hydration. One should consume adequate fluids during the period before an event and drink about ml about ounces of fluid about before exercise to promote adequate hydration and allow time for excretion of excess ingested water. T minimize risk of thermal injury and impairment of exercise performance during exercise, fluid replacement should attempt to equal fluid loss. At equal exercise intensity, the requirement for fluid replacement becomes greater with increased sweating during environmental thermal stress. During exercise lasting longer than h, a carbohydrates should be added to the fluid replacement solution to maintain blood glucose concentration and delay the onset of fatigue, and b electrolytes primarily NaCl should be added to the fluid replacement solution to enhance palatability and reduce the probability for development of hyponatremia. During exercise, fluid and carbohydrate requirements can be met simultaneously by ingesting – ml h- of solutions containing – carbohydrate. During exercise greater than h, approximately of sodium per liter of water would be appropriate to replace that lost from sweating.
This pronouncement was reviewed for the American College of Sports Medicine by members-at-large, the Pronouncement Committee, and by: David L. Costill, PhD, FACSM; John E. Greenleaf, PhD, FACSM; Scott J. Montain, PhD; and Timothy D. Noakes, MD, FACSM.
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American College of Sports Medicine. Position Stand on Heat and Cold Illnesses During Distance Running. Med. Sci. Sports Exerc. any recreational and elite runners participate in distance races each year. When these events are conducted in hot or cold conditions, the risk of environmental illness increases. However, exertional hyperthemia, hypothermia, dehydration, and other related problems may be minimized with pre-event education and preparation. This position stand provides recommendations for the medical director and other race officials in the following areas: scheduling; organizing personnel, facilities, supplies, equipment, and communication; providing competitor education; measuring environmental stress; providing fluids; and avoiding potential legal liabilities. This document also describes the predisposing conditions, recognition, and treatment of the four most common environmental illnesses: heat exhaustion, heatstroke, hypothermia, and frostbite. The objectives of this position stand are: To educate distance running event officials and participants about the most common forms of environmental illness including predisposing conditions, warning signs, susceptibility, and incidence reduction. To advise race officials of their legal responsibilities and potential liability with regard to event safety and injury prevention. To recommend that race officials consult local weather archives and plan events at times likely to be of low environmental stress to minimize detrimental effects on participants.
To encourage race officials to warn participants about environmental stress on race day and its implications for heat and cold illness. To inform race officials of preventive actions that may reduce debilitation and environmental illness. To describe the personnel, equipment, and supplies necessary to reduce and treat cases of collapse and environmental illness.
This document replaces the position stand titled The Prevention of Thermal Injuries During Distance Running. It considers problems that may affect the extensive community of recreational joggers and elite athletes who participate in distance running events. It has been expanded to include heat exhaustion, heatstroke, hypothermia, and frostbitethe most common environmental illnesses during races.
Because physiological responses to exercise in stressful environments may vary among participants, and because the health status of participants varies from day to day, compliance with these recommendations will not guarantee protection from environmentally induced illnesses. Nevertheless, these recommendations should minimize the risk of exertional hyperthermia, hypothermia, dehydration, and resulting problems in distance running and other forms of continuous athletic activity such as bicycle, soccer, and triathlon competition.
Managing a large road race is a complex task that requires financial resources, a communication network, trained volunteers, and teamwork. Environmental extremes impose additional burdens on the organizational and medical systems. Therefore, it is the position of the American College of Sports Medicine that the following RECOMMENDATIONS be employed by race managers and medical directors of community events that involve prolonged or intense exercise in mild and stressful environments.
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