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Higher prevalence of exercise-associated hyponatremia in female than in male open-water ultra-endurance swimmers: the ‘Marathon-Swim’ in Lake Zurich

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Abstract

We investigated the prevalence of exercise-associated hyponatremia (EAH) in 25 male and 11 female open-water ultra-endurance swimmers participating in the ‘Marathon-Swim’ in Lake Zurich, Switzerland, covering a distance of 26.4 km. Changes in body mass, fat mass, skeletal muscle mass, total body water, urine specific gravity, plasma sodium concentration [Na+] and haematocrit were determined. Two males (8%) and four females (36%) developed EAH where one female was symptomatic with plasma sodium [Na+] of 127 mmol/L. Body mass and plasma [Na+] decreased (p < 0.05). The changes in body mass correlated in both male and female swimmers to post-race plasma [Na+] (r = −0.67, p = 0.0002 and r = −0.80, p = 0.0034, respectively) and changes in plasma [Na+] (r = −0.68, p = 0.0002 and r = −0.79, p = 0.0039, respectively). Fluid intake was neither associated with changes in body mass, post-race plasma [Na+] or the change in plasma [Na+]. Sodium intake showed no association with either the changes in plasma [Na+] or post-race plasma [Na+]. We concluded that the prevalence of EAH was greater in female than in male open-water ultra-endurance swimmers.

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Acknowledgments

The authors thank the crew of ‘Sri Chinmoy Marathon Team Switzerland’ for their support in collecting data. Mary Miller from England helped us in the translation.

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Authors and Affiliations

  1. Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland

    Sandra Wagner, Beat Knechtle, Christoph Alexander Rüst & Thomas Rosemann

  2. Gesundheitszentrum St. Gallen, Vadianstrasse 26, 9001, St. Gallen, Switzerland

    Beat Knechtle & Patrizia Knechtle

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  1. Sandra Wagner
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Correspondence to Beat Knechtle.

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Communicated by Susan A. Ward.

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Wagner, S., Knechtle, B., Knechtle, P. et al. Higher prevalence of exercise-associated hyponatremia in female than in male open-water ultra-endurance swimmers: the ‘Marathon-Swim’ in Lake Zurich. Eur J Appl Physiol 112, 1095–1106 (2012). https://doi.org/10.1007/s00421-011-2070-5

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