Runners in Mon.'s #bostonmarathon, facing near 90° temp., should RESIST the urge to guzzle a lot of water. #chandelli Let me explain...



Many summers ago, a controversial article about a local race appeared under a six-column headline in the Norwich, Connecticut, morning newspaper. The story defined a distinctive but universal group of people -- healthy race-day distance runners. The timing was right. Four days later, the largest-ever running field in southeastern Connecticut -- some 700 runners -- was expected for the city's annual 10.6 mile road race. Sweltering heat was forecast and the race course was particularly hilly.



Nonetheless, the story described healthy road racers in part as those who eschew "obsessive drinking habits over the first couple miles" and who do not guzzle water when they feel the first effects of the heat. "A drinking splurge this early," the article concluded, "often spells disaster later in the race." The description was 180 degrees from an accepted group stereotype, that on race day, healthy distance runners ultrahydrate.



The backlash was prompt and public. Some readers called the newsroom to protest. On race morning, a frail, silver-haired race marshal was incandescent.



"Forget what you may have read! Take water now and early in the race!" he barked repeatedly into a bullhorn near the city-square starting line. At one point, he spotted an editor from the newspaper. He lowered his device but snapped, "Let's hope no one dies!"



The editor explained that the story was purposely assigned to a college student who was also a seasoned competitive distance runner. The race official said his own message was fueled by a more reliable source -- logic.



Group stereotypes too often do that, use logic to trump reality. For Ziva Kinda, a professor of psychology at the University of Waterloo in Ontario who has studied stereotypes for many years, there's an explanation for -- and, it turns out, a real concern with -- groups being on the flipside of common beliefs about them.



Kinda has learned that when we believe an inaccurate group stereotype, our becoming familiar with true average members of that group leads us to MORE strongly accept the inaccurate stereotype. We convince ourselves that the exception proves the rule. "It is ironic," Kinda notes, "that the more individuals deviate from the stereotype of their group, the less likely they are to bring about stereotype change. One disturbing implication is that the more inaccurate our stereotype of a group, the less likely it is to change spontaneously following encounters with group members."



Assumptions guide our thinking. Indeed, nearly a quarter century after I wrote the article about healthy distance runners for the Connecticut newspaper, a study about runners' water intake published in the New England Journal of Medicine would change the world of competitive distance running. Because of the report and related findings, medical officials at the nation's governing body of competitive running -- USA Track and Field -- and such leading distance races as the New York City Marathon and, yes, Boston Marathon, would rewrite their guidelines and send notices to runners urging them to correct an assumption that could be proved fatal.



The 2005 study warned of a little-known medical emergency -- hyponatremia, or too much water -- that had been identified as the source of some runners' deaths. The report explained that if a runner consumes more water than he loses, he can seriously dilute his blood and lower his sodium concentration, which may result in seizures, coma and death.



Because the kidneys cannot deplete excess water, runners who continue drinking allow that water to enter their cells, including brain cells. Expanded brain cells push against the skull and can compress the brain stem. Breathing and other vital functions are controlled by the brain stem, so hyponatermia can be fatal. Three or fewer liters of water -- the amount depends on the individual -- can cause complications. The typical victim is someone who is concerned about being adequately hydrated.



The study's lead author, cardiologist Christopher Almond of Children's Hospital Boston, said he had first known of hyponatremia in 2001. The study found that in the 2002 Boston Marathon, 13 percent of the competitors had reached life-threatening hyponatremia. In the same race, a 28-year-old woman died miles before the finish line, a victim of the condition. Hyponatremia also explained the death of a 35-year-old woman in the same year's Washington, D.C., marathon.



Marvin Adner, as medical director of the Boston Marathon, said, "Before this study, we suspected there was a problem. But this proves it." Tim Noakes, a renowned hydration expert at the University of Cape Town who said he first sensed more than 30 years ago that there was a problem with long-distance runners gulping liquids, said sports-drink companies are partly to blame, for making "hydration a medical illness that was to be feared... Everyone becomes hydrated when they race. But I have not found one death in an athlete from dehydration in a competitive race in the whole history of running. Not one. Not even a case of illness."



Paul Thompson, a Connecticut cardiologist and competitive distance runner, now advises runners to only drink while in motion. "If you stop and drink a couple of cups, you are overdoing it," he said. Advises Adner, "Don't start chugging down water." The International Marathon Medical Directors Association has released guidelines that runners shouldn't drink ahead of their thirst. Danger typically surfaces in hyponatremia victims because they are used to monitoring their risk level by the heat level of their skin. Yet, hyponatremia does not make the skin hot nor heighten the core body temperature.



Which is why it wasn't until one of my track coaches in college was told of some preliminary research on water intoxication that he realized a couple of my teammates' tanking up on water for all-out runs in Alabama one summer had led to their similar headaches and disorientation. Logic had failed them. After years of running, one of the stereotypes of distance runners had, too.



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