Deborah Cohen

Highlights...

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In the 1970s, marathon runners were discouraged from drinking fluids for fear that it would slow them down, says Professor Tim Noakes, Discovery health chair of exercise and sports science at Cape Town University.

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An investigation by the BMJ has found that companies have sponsored scientists, who have gone on to develop a whole area of science dedicated to hydration. These same scientists advise influential sports medicine organisations, which have developed guidelines that have filtered down to everyday health advice.

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One drink in particular was quick to capitalize on the burgeoning market. Robert Cade, a renal physician from the University of Florida, had produced a sports drink in the 1960s that contained water, sodium, sugar, and monopotassium phosphate with a dash of lemon flavouring. Gatorade—named after the American Football team, the Gators, that it was developed to help—could prevent and cure dehydration, heat stroke, and muscle cramps, and improve performance, it was claimed. Gatorade documents from 2010 show that sales staff are encouraged to watch an internal video called “Selling the Science” and told to “make sure consumers understand the science behind Gatorade.” Promotion also hinges on the notion that sports drinks are among the “best researched food products on the planet,” Bob Murray, a former director of the Gatorade Sports Science Institute wrote in 2001.

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And they’re not the only ones—when GSK reshuffled its entire communications department earlier this year, it said a key part of its strategy would be promoting the science behind its products. “The science that goes into our brands is a competitive advantage. Lucozade, for example, is subject to more than 100 clinical trials,” a spokesperson said. The company has suggested that the “market is all about credibility.”

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In recognition of this, GSK set up the Lucozade Sports Science Academy (LSSA) in 2003, comprising a sports nutrition website, links with leading universities, and a high-tech gym at the company’s headquarters. Marketers intended that bottles of the drink would be stamped with the LSSA insignia to reaffirm the scientific credibility when sports nutrition toolkits were handed out to gym instructors to educate them in the use of Lucozade Sport products.

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Indeed, just as drug companies have appointed key opinion leaders to influence doctors’ prescribing patterns, sports drink and supplement companies seek to work with gyms and instructors. Virgin Active has a partnership with Powerade, for example, and the GSK owned supplement brand, Maximuscle, has a partnership with LA Fitness. Like GSK, Gatorade has pushed heavily on the science. In 1985, Gatorade, then owned by Quaker Oats, set up its Gatorade Sports Science Institute (GSSI) in Barrington, Illinois, to conduct and publish research and to educate sports health professionals and athletes on sports nutrition and exercise science.

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Just as drug companies held sponsored symposiums in exotic locations, Quaker Oats held invitation only annual conferences in locations around the world . Attendees included advisers to the world’s most influential sports authorities.

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Indeed, the editors of a sports medicine book on performance were among them. Ron Maughan, Louise Burke, and Edward Coyle, coeditors of Food, Nutrition and Sports Performance II: The International Olympic Committee Consensus on Sports Nutrition, published in 2004, all have financial links (personal or institutional) to Gatorade and their book was supported by Coca-Cola, the makers of Powerade.

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“Drink small amounts frequently, even if you are not thirsty— approximately 150 ml of fluid every 15 minutes—because dehydration dramatically affects performance.”

Studies suggest that thirst is a more reliable trigger. A meta-analysis of data from cyclists in time trials concluded that relying on thirst to gauge the need for fluid replacement was the best strategy.

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Four years later, in 1996, the American College of Sports Medicine produced guidelines that adopted a “zero % dehydration” doctrine, advising athletes to “drink as much as tolerable.” This guidance grew out of a roundtable meeting in 1993 “supported” by Gatorade. A literature review in a nephrology journal also backed this up saying there is no evidence that “consumption of sports drinks (electrolyte-containing hypotonic fluids) can prevent the development of exercise associated hyponatraemia.” Coca-Cola, for example, acknowledges that hyponatraemia is a cause for concern “for anyone doing endurance sports,” but says that this is due to the failure to “replace the sodium lost through sweat or drinking a very large volume of very low-sodium beverages such as water.”

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One lesson looks at osmosis and water: “During intense exercise, heavy sweating removes water and salts from the body. If large quantities of water alone are consumed, this will dilute the normal concentrations of sugars and ions in the blood and tissues. Water will enter, by osmosis, and stop the muscles, nerves and the brain from working properly. In extreme cases, water intoxication can occur and may lead to death,” it says. Students are then asked which drinks are closest to being isotonic and whether sports drinks justify their prices.