Journal Title (Medline/Pubmed accepted abbreviation): Int J Sports Med
Page numbers: 815
doi (if applicable):10.1055/s-0031-1286300
Article type: Letter
Summary of letter:
The authors have written a response to comments made by Dr. Shepard (Shepard RJ. Int J Sports Med. 2011;32:814) regarding their study. An objection to using incidence rate (per 10,000 participants) with such a small number of participants was acknowledged. However, the authors provided these data to compare their data with previous studies. Also, the authors agreed that a blood sodium concentration of 134 mmol/L is usually asymptomatic, but the runner in question had clinical symptoms of hyponatremia and was admitted to the onsite medical tent. The authors do agree that runners could have started the race hyponatremic, which was not determined in the study and was acknowledged as a study limitation.
Interpretation of findings/Key practice applications:
The authors were pleased that Dr. Shepard agreed with the key point of the study, which was the importance of fluid regulation during distance running under tropical conditions. Overhydration can occur in the tropics and can lead to hyponatremia.