March 15, 2005
Hello!
Last month (February
2005), a college student died after drinking too much ... water.
"A Chico fraternity
pledge died of water poisoning, authorities said Thursday as experts
warned that the dangerous hazing ritual has killed at least one
other person as fraternities are replacing alcohol bingeing with
excessive water-drinking. ... Water bingeing is becoming an increasingly
common hazing ritual, especially inside rogue frat houses such
as Chi Tau, said Hank Nuwer of Indiana, a national expert on hazing
and author of four books on the topic. ... '[T]hey think water
is safer than alcohol, but it can also be deadly.' Forced water
consumption and heavy exercise are known to dilute the salt content
of blood to the point where it interferes with brain, heart and
muscle function. Without enough sodium, the brain swells and victims
can suffer fatal comas.... "
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/02/04/BAGNSB576121.DTL
This is not an isolated
incident.
"In March 2003,
State University of New York freshman Walter Dean Jennings III
was pledging a renegade fraternity that had also been expelled
over drinking violations. He was forced to drink so many pitchers
of water through a funnel that the sodium in his body dropped
to lethal levels and his brain swelled. The autopsy confirmed
he died of hyponatremia."
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/02/04/BAGNSB576121.DTL
And then there are incidents
of the other extreme:
"The Interfraternity
Council late Monday night unanimously voted to withdraw its recognition
of the Sigma Chi fraternity following the alleged hazing of a
pledge who was hospitalized for kidney failure. ... Greek Life
Assistant Director John Duncan said the student and seven other
members of his pledge class were 'not given much food or water
and they had to do an extensive amount of exercise for an extended
period of time.' Sometime after the initiation, the student, a
Kinesiology junior and Ann Arbor resident, reported the incident
to his family, who drove him to a nearby hospital. He was admitted
Sept. 14 [2003] with muscle breakdown, which led to acute renal
failure. ... The student was released from the hospital Sept.
19. University officials said he is still recovering."
http://www.michigandaily.com/vnews/display.v/ART/2003/09/24/3f7121d4cba5
Even for those who might
not be aware that drinking too much water can be a health concern,
drinking too little -- especially when exercising for an extended
period of time -- is something that most, if not all, of us have
been cautioned to avoid at some point in our lives.
"For years, runners
have been told repeatedly that it's a good thing to drink -- and
to drink often. Now it appears there can be too much of a good
thing. To be sure, dehydration is not to be ignored. You should
still consume plenty of sports drinks. But drinking large amounts
of water can spell trouble. When you saturate your body with water,
you can develop a life-threatening condition known as hyponatremia,
a shortage of sodium in the blood. It occurs when runners sweat
excessively, lose too much salt, and then drink excessive amounts
of water -- which dilutes the blood's sodium content even more.
This imbalance can cause fatigue, weakness, cramping, nausea,
vomiting, bloating and puffiness in the face and fingers, dizziness,
headache, confusion, fainting and unconsciousness, pulmonary edema
(fluid in the lungs), seizures, coma -- and sometimes even death."
http://www.runnersworld.com/article/0,5033,s6-78-79-0-438,00.html
Even if you are not planning
to join a fraternity, or the track team, any time soon, you still
make choices about what you eat and drink each day.
"Though uncommon,
it's possible to drink too much water. Drinking excessive amounts
can overwhelm your kidneys' ability to get rid of the water. This
can lead to hyponatremia, a condition in which excess water intake
dilutes the normal amount of sodium in the blood. People who are
older, who have certain medical conditions such as congestive
heart failure and cirrhosis, or who are taking certain diuretics
are at higher risk of hyponatremia."
http://www.mayoclinic.com/invoke.cfm?id=NU00283
Diuretics?
"Diuretics ... These
drugs act on the kidneys to increase urine output. This reduces
the amount of fluid in the bloodstream, which in turn lowers blood
pressure."
http://www.chclibrary.org/micromed/00045620.html
So, you don't take any
medications, and you don't have any health conditions that could
be possible risk factors. If you are eating on the go throughout
the day, you should be aware that:
"Of note, people
whose diets include a high intake of fluids and much reduced protein
and sodium are at risk for hyponatremia, which can cause fatigue,
confusion, dizziness, and in extreme cases, coma."
http://www.umm.edu/patiented/articles/what_weight_control_dietary_approaches_type_2_diabetes_000042_4.htm
Or, the other extreme:
"[T]he significant
weight loss proclaimed by dieters eating high fat high protein
diets [ketogenic diets] is mainly due to excessive dehydration.
This excessive load placed on the kidneys increases fluid loss
coupled with glycogen depletion accounting for significant weight
loss from water! In addition, the reduced carbohydrate intake
will influence protein catabolism. Losses of lean tissue are eminent
due to the need of the body to recruit amino acids for the maintenance
of body glucose (gluconeogenesis). ... Implications for the active
individual are even more severe. Since carbohydrates are the body's
primary provider of energy for activity, the end result is a decrease
in ability to train and compete. When compared to a well-balanced
calorie restricted diet, the ketogenic diet offers no advantages
in facilitating weight loss. On the contrary the ketogenic diet
does offer; raised serum uric acid levels, altered electrolyte
concentrations - linked with cardiac arrhythmias, acidosis, aggravated
kidney problems, elevated blood lipids, depleted glycogen storage
reserves, and dehydration."
http://www.ncsf.org/tools/articles/articles-20.aspx
Ketogenic diets?
"ketone: a chemical
produced when there is a shortage of insulin in the blood and
the body breaks down body fat for energy. High levels of ketones
can lead to diabetic ketoacidosis and coma. Sometimes referred
to as ketone bodies."
http://diabetes.niddk.nih.gov/dm/pubs/dictionary/K-O.htm
With all this talk about
hyponatremia, and even dehydration, there should at least be mention
of hypernatremia...
"Hypernatremia is
high sodium in the blood that occurs with excessive fluid loss.
When fluid is lost and not replaced, sodium is not adequately
excreted from the body. The following are causes: Diabetes insipidus
(caused by deficiency of or insensitivity to ADH), Diarrhea, Diuretic
medication, Excessive salt intake. Excessive vomiting, Heavy respiration
(e.g., exercise, exertion), Severe burn, Sweating. It is associated
with the same symptoms as hyponatremia, and also causes the following:
Delerium, Irritability, Muscle twitching..."
http://www.nephrologychannel.com/electrolytes/hypernatremia.shtml
Those involved with hazing
were trying to make things safer, or trying to get around alcohol
regulations, or maybe both. For years, those exercising or participating
in sports have been told to be sure to drink enough water. Dieters
have also been told to drink more water to help them lose weight.
We have heard about the risks of drinking too little water, but
rarely do we hear about the risks of drinking too much.
Questions of the Week:
Now that you know about hyponatremia, how can you avoid it? What
would cause you to tell a friend about it? What should your friends
and peers know about this rare, but life-threatening condition?
What groups of people do you think are most at risk? How can people
avoid dehydration while not putting themselves at risk for hyponatremia?
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Cindy
aehealth@yahoo.com
Health Community Coordinator
Access Excellence @ the National Health Museum
http://www.accessexcellence.org