Paintball Park Is A Family Spot For Sport

Paintball is one kind of sports. In some areas is famous as an exciting as well as fun activity. Many of us have heard that it is an extreme sport. For such kind of fun and activity many specialized paintball park are designed for the whole family. Like any sport, paintball has a range of levels as well as types of games to play. Paintball is a family sport.

To play this game you will also need a paintball gun and a supply of paintballs. You can often rent a gun at a facility specially designated for paintball games. For a nominal fee, you can also purchase paintballs, but it may be better to buy your own from a local warehouse store, as you can usually get more for less.

In addition, kids who are upset straightforwardly by small injuries should be discouraged from participating in a paintball game. Not only will they be hit by paintballs, they may also be prone to tripping and falling as they trick through their environment during game play.

Actually, when the weather is fair that time it suggested that plan a family trip for paintball game and go to any Paintball Park. However, sometime it has been that many time paintball players try to choose a place to play in sparsely populated areas, such as nearby wilderness. It is advisable that always try to avoid playing in snow and ice, as the presence of these wintry conditions will increase the likelihood of serious injury.

To play paintball in Paintball Park with paintball gun is really one of those activities that most people love to do. The game has already been recognized as a sport. Aside from being just a game and a sport, paintball is also known as a military training. In this type of game, the players wear vests as well as protective gears. Moreover, players have paintball guns with them which they use to shoot their opponents. Since the game has been introduced around the world as a sport, there are already lots of competitions being held on different paintball fields in different countries.

We have seen that in every sport I know of, the biggest reason people habitually get frustrated or give up is due to lack of proper gear. This should be done after either renting or starting with a low-cost set of gear. Then after you have experienced the game for a little while, upgrade your paintball guns and gear to the style of play you are comfortable playing.

So, buy proper gear and paintball gun, plan the trip for weekend with family for paintball sports. We know that in family always there are persons with different age but we assure that once you reach at the Paintball Park, all will get one kind of sprit to play this game. Such kind of sports is designed to make you physically fit; however, it is advisable to take care of few points before going to start with this sports.

Rock Climbing – A Sport And A Passion

Climbing has been around as long as people have inhabited the earth. Even the cavemen had to learn to climb mountains and hills in order to find food and shelter. Today climbing may not be necessary for survival, but it sure is a great way to get in shape and a sport that millions are very passionate about.

Perhaps you hadn’t considered climbing as a fitness tool, but think about it a moment. One needs flexibility, strength, muscle control and balance, all of which promote physical fitness. Many people are tackling the rock climbing walls at their local gym and finding their fitness levels increasing while having fun!

Of those that begin with the indoor rock climbing walls, many become passionate fans of the sport and venture to outdoor rock climbing. It is a physical as well as mental exercise. You can quickly see how your endurance and stamina increases as your rock climbing abilities increase.

Many gyms have entire programs designed around climbing and once you master that, it is easy to find others that share your passion outdoors as well. The numbers of climbers are growing with each passing year! It is a great stress reliever and brings us back to the basics of feeling a sense of actual accomplishment using our bodies as well as our brains.

To start out all you need to do is find a gym that has the indoor climbing wall, a pair of beginner climbing shoes and a good trainer. Before you know it you will be feeling the desire to tackle Mount Kilimanjaro and stand on the roof of Africa!

How To Turn Your Love For The Sport Of Basket Ball Into A 6-figure Income In As Little As 6 Months.

I like basketball, but I’m not passionate about it. However, if you are, you can use that passion to start your own website based abound the subject of basket ball.

Many basketball fanatics, visit websites all the time, not realizing the owner of that site is somebody just like them, who loves the sport, and decided to earn a living off of it.

Launching your own basketball website, is how you can pour your passion for basketball into a career that keeps you stimulated and pays the bills.

You don’t need a massive website with hundreds of pages. In fact, all you need is a single web page…that’s it! This web page will allow you to build your own mailing list of basket ball fanatics who will fill your bank account with money on a regular basis.

I know that sounds hard to believe, but Internet marketers such as myself, do it all the time. We build a one-page web site, based on a niche topic, designed to attract and invite like-minded individuals to join our mailing list.

After a few months of aggressive promotion, we establish a mailing list of thousands of subscribers who we communicate with via email and recommend niche related products to.

In most cases, the products are not even our own. We simply sign up for affiliate programs and earn commissions by recommending other people’s products through a unique affiliate link that tracks our sales.

It’s a very simple process. Here is a brief overview tailored to the basketball niche.

1. Build a single web page offering a basket ball ebook or some other basket ball related product for free download if they join your mailing list. Many times, you can find niche related ebooks that have resell rights which you can offer as your free download.

2. Promote your web page on the Internet in order to acquire mailing list subscribers. There are tons of free ways to promote your web page.

3. Recommend basketball related affiliate products to your mailing list subscribers and earn commissions for any resulting sales.

Affiliate amrketing involves building a relationship with your mailing list subscribers by communicating with them via an automated mass email system, called an autoresponder. Unlike SPAM, this is permission based email which requires people to subscribe in order to receive your mailings.

You can talk about whatever you like, player stats, your old high school basket ball team, training techniques, your kids little league team, the NBA, ANYTHING…as long as it relates to basket ball.

Occasionally you will find basket ball related affiliate products that you can elegantly recommend to your mailing list subscribers. Once you have grown a large mailing list, you can earn thousands of dollars with the click of your mouse, in just a single email broadcast.

Affiliate marketing can be an extremely fulfilling (and profitable) career when you focus on a topic you love.

A Modern Water Sport For Modern People- Stand Up Paddles

People love different sports but now a day the popularity of water sports is increasing gradually as it is the most adventures and awesome exercise such that you could make yourself healthy very easily. These games are well liked in the sea regions and rivers area because it is water based game.

Stand up paddle boarding, also known as SUP is a recent sport that is becoming much popular. In this game, you stand upright on the skateboard and use a long paddle to move forward in the water. This activity can be done in sea, rivers, lakes and many other places in which water is associated. You can enjoy your gaming experience in either calm water or moving water; if you like some adventures, then you can try in the storm like situation in the river or sea. .

You need a paddle in addition with the board to make yourself moving in the water. Before choosing the paddle, you should consider its height; always purchase it near about six inches long as compared to your height.

The most interesting fact about stand up paddle is- women are perfect for these games as compared to the men as their center of gravity is slightly lower. Therefore, the women can get the wonderful thrill just by going in the water with the board.

In the market there is various manufactures are available in, you can choose the perfect one as for your requirement and budget. However, always go for the better one as it will be the best and long lasting on the other hand the poor one seems good deal in the beginning but as the time passes you suffers more.

Benefit of water Sport

An adventures game allows you to explore more in water.

It has wider health benefits that help to make you fit.

SUP is very popular among the teenagers as well as all aged people except child. Suppose that you are tensed and want to overcome from it, just get outside from your home with these boards and go on water and start surfing, of course you will get calm. So do not be late go and purchase it.

This game offers you opportunity to see the waves very closely. A modern surfer always loves to surf on the water when getting bigger waves in the sea no doubt it gives them a breathtaking enthusiasm and pleasure.

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Graco Quattro Tour Sport

The Graco Quattro Tour Sport baby stroller is the perfect combination of comfort, durability and life simplifying features. It’s Graco’s best seller and rightly so.

Graco actually offers two different versions of this model, the Graco Quattro Tour Deluxe and the Graco Quattro Tour Sport. The Sport model is more expensive; Graco lists the Quattro Tour Sport at $189.99 and the Quattro Tour Deluxe at $159.99.

The Graco Quattro Tour Sport comes with stronger, more- flexible front suspension. The Graco Quattro Tour Sport’s frame is a bit different. It has a more sleek (sporty) design while it also has a smaller foot rest for the baby and slightly different grip set up.

The Graco Quattro Tour Sport’s aluminum frame is durable and strong enough to support a child up to 50 lbs, and will easily last you past the toddler years. The suspension and wheels are great on the Graco Quattro Tour Sport! Unlike many strollers in it’s class, it has large rubber wheels instead of plastic. Plastic wheels grind down and have to be replaced.

The wheels combine with a strong front suspension to allow for maximum maneuverability and versatility. Don’t be afraid to take this stroller on grass, gravel or uneven sidewalks. A one touch rear braking system allows for maximum safety and simplicity.

Hands down the best feature of the Graco Quattro Tour Sport baby stroller is the one-handed gravity fold system. With one hand the stroller folds and gravity takes care of the rest! Your baby will appreciate the multi-position fully reclining seat, while being protected by a very large 180 degree rotating canopy with “peek-a-boo” window.

The Graco Quattro Tour Sport has both parent and baby trays each with two cup holders. There is even a time and temperature read out on the parent’s tray. The baby tray pivots outward to allow easy access to the cushioned seat, removable head support and 5 point safety harness. The large under carriage storage area is perfect while shopping or on a long trip.

The Graco Quattro Tour Sport seat’s material is comfortable, stylish and available in a variety of gender neutral patterns and combinations. It’s also machine washable and stain resistant, which is a life saver!

The only complaint we have found about this stroller is the weight and the size when folded. At 26.5 pounds, I don’t personally think it’s heavy, but some people do. Others have said it takes up a lot of room in their trunks.

While the price is a bit higher, if you plan on tackling more than just suburban sidewalks, the Graco Quattro Tour Sport is worth the extra money.

The Graco Quattro Tour Sport are excellent baby strollers. They combine stability, durability and a host of options that will make your life a lot easier. While the weight is an issue to some people, you don’t buy a baby stroller like the Graco Quattro Tour Sport because it’s compact. You are looking for comfort, convenience and safety. The Graco Quattro Tour Sport provides all of that and more, at a very reasonable price.

Sport Fishing Competitions and How You Can Enjoy Them!

What is sport fishing? You could be competing for a trophy or you may be looking to catch the largest fish from all of your friends. Competitions are by far the most popular reason for sport fishing though. You can go both still fishing or fly fishing. You’ll have a specific time frame and depending on the weight and the species that you catch, you may just bring home the big one. The type of line that you use is also important here. The heavier the line, the fewer points you’ll get.

There are different types of sport fishing. Bass fishing, shore fishing, fly fishing, big game fishing, troll fishing and ice fishing are some of them. The competitions are based on the group of anglers, the conditions and the type of fish they are after. There is a wide range of options out there. You’ll be able to catch fish like marlin, walleye, salmon, shark, tuna and a wide range of others. Equipment You’ll Need

The equipment you need depends on what type of fish you are after as well as what type of fishing you are doing. You’ll need to have the basics of rod, reel and tackle. Some will allow you to bring along your fish finder while others will not. Make sure you take a moment to see what the rules say.

For bait, you’ll need to take with you’re the bait that works for the fish you are after of course. You can go from simple things such as lures and spinners to wet and dry flies, shrimp or live fish and other live bait.

Understanding Fishing Line

The type of line used in these tournaments is often lighter than the force that the fish applies to it. Why? It’s more of a challenge of course! You should purchase a high tech drag mechanism on your reel to compensate for this. This will keep the right tension in the line when the fish takes off. Only when the fish gets tired of running will you have the ability to land him. It can be quite challenging but that is what makes it so fun, right!

How To Fight The Big Guy

There are several methods that are used to fight hooked fish. One is the use of a game chair. The fisherman sits there and places the butt of his rod in a gimbaled mount. You’ll need quite a long rod for this and it needs to be bent correctly to fit properly. This is not an easy task and you’ll need experience to get it right. Or, you can go with the stand up method. You’ll use a harness this time around. You’ll need to eat your Wheaties for this one though.

Ready to give it a try? You may find yourself shocked by the price of it all. It can cost you up to $25,000 if you purchase everything. You can take advantage of charter services though which will cut down on the supplies (especially your boat!) and you’ll get everything that you need. Take the time to learn with a professional to help you to make the most out of every tournament you enter. Winning the prize can help to lower these costs and make it all well worth it!

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Brilliant Sport Footwear

Triathlon is a special sort of sports event that completes within three stages viz. swimming, biking and running within the same event. The diversity of landscape as well as bodily environment has led to development of unique products just for safety. Triathlon footwear are a fundamental element of the entire gear. These footwear are just like those of bicycling footwear however they also sport an additional automatic holding cleat which snaps the cyclists feet to the pedals. Such design is used keeping in view the risks active in the event. You can use all of them with no socks; have openings within the sides allowing water to be able to drain away quickly. Unlike three straps, shoelaces or, ratcheting buckles found on modern day road race shoes, these shoes only have 2. Additionally, this kind of shoes have untraditional settings of having the open straps away from the chain and cycles hence preventing the possibility of entangling them if you pedal using unstrapped shoes. Triathlon bike shoes often feature elastic laces. This gives the participant setting the tension before hand and then pulling the lace of the shoe with out avoiding to tie them up. This eliminates the wastage of your time during the bike-to-run transition. These shoes also provide openings within the bottom to allow water to drain off hence enabling the footwear to become unsaturated and lightweight.

Shimano shoes provide a wide number of shoes to pick from. Each one of them supplements various need for distinct type of bicycling sports. There’s a footwear that suits each riding style. Shimano’s quality has been proven in the form of unmatched designing and uncompromising product quality which have got mettle to satisfy any kind of undesirable circumstances. Shimano footwear are available in two major classes which are mountain footwear and road and tri shoes. Mountain shoes possess sub-categories such as mountain competition-custom fit, mountain sport, mountain touring, all-mountain & BMX as well as inside cycling shoes. Road and tri shoe comprises of road competition-custom fit, road competition, road sport, and road traveling and triathlon footwear. Mountain series Shimano shoes offers effectiveness, health and fitness, balance and sturdiness that are necessary from an individual’s potential point of view. These kinds of footwear appeal to several kind cyclists, aggressive riders, off-road enthusiasts, touring cyclists and health and fitness fanatics while keeping an informal as well as good look. Here indoor biking shoes are constructed with latest light-weight material that maximizes comfort, coolness as well as breathability. The road as well as tri series footwear mix functions such as stability, rigidity as well as light weight. The triathlon shoes in Shimano sport high air flow, smooth interiors as well as fast drying mesh for superior comfort and ease with out socks.

Sidi shoes is regarded as to become a well known manufacturer for bicycling shoes. Its non-MTB footwear were utilized by many famous cyclists in the past who won crucial races including world championships. Original shoes had wooden soles and leather upper but since 80?s plastic and carbon fiber is being used in order to produce them. Sidi cycling shoes footwear have normally much less wide toe area which keeps the feet firm and limited in its position. Numerous popular Moto Gp drivers have sponsored SIDI shoes for instance Alex Barros, Anthony West, Colin Edwards, Loris Capirossi etc.

Spor Haberleri Sport News Channels

S??rt? news i? now g?ing to be ?n ????nti?l component of ?ll th? n?w? related media. By th? ?dv?nt ?f inf?rm?ti?n technology, now nobody h?? t? think ?b?ut ?n? ???rt event th?t ?n? h?? mi???d du? t? work ?r any ?th?r ??mmitm?nt. Ev?nt b???d ?nd t?urn?m?nt r?l?t?d n?w? are b?ing u?d?t?d now ?v?r th? w?b ?nd ?n th? other m?di? ??ur??? round th? ?l??k. Sports n?w? ?nd ??v?r?g? ?r? ?n the in?r???? in their im??rt?n?? ?? w?ll ?? volume ?v?r? ?ingl? d??. It is just b???u?? of b???t in w??lth, f?m? ?nd recognition.

A numb?r ?f sports ?h?nn?l? ?nd magazines are d?di??t?d t? provide vi?w?r? with th? latest round u? ?nd updates ?f ???rt? ?v?nt? g?ing ?n over th? gl?b?. B?ing efficient in bringing ?ll the sport vi?w?r? t? ?n ?x?iting exposure ?f wh?t’? h????ning ?v?r? ?ingl? moment in various ???rt? in diff?r?nt ??rt? of w?rld, spor haberleri h?v? b???m? ?n ?m?rg?nt ??ur?? ?f entertainment. Now you ??n b? w?ll ?w?r? ?f wh?t?v?r h????ning in diff?r?nt m?t?h??, competitions ?nd tournaments of th? ???rt ?f ??ur interest. /p>

Ti?king ???r? b??rd?, tight m?t?h ?itu?ti?n?, ti?? in t?urn?m?nt? ?ll are th? thrills ?f ???rt? whi?h have g?n? now a very ?ff??tiv? ??ur?? ?f ?nt?rt?inm?nt. M?t?h reviews, ?x??rt ??ini?n?, current rankings ?f diff?r?nt ?l???r? ?nd teams r?l?t?d t? v?ri?u? ???rt? ?r? m?king ????l? m?r? and m?r? ?rud?nt to und?r?t?nd ?nd get ?qui???d with ???rt sense. Al??, ?u?h kind ?f ?u???rtiv? ??tiviti?? ?r? ??ting as great ??ur?? ?f sport promotions.

St?ri?? ?b?ut players, teams ?nd w?rd? form ????h?? ?r? n?w making son dakika spor haberleri a fully entertaining ?tuff. Sports j?urn?li?t? have t? work thr?ugh with gr??t ??mmitm?nt and ?r?f???i?n?l ?thi?? in order t? g?t u?d?t?? ?nd stories from ?l???r?. Th??? journalists do tr?v?l ?l?ng with t??m? ?nd are ?lw??? keen t? kn?w ?t?ri?? b?hind the inf?rm?ti?n, ?? it i? much insufficient to b? just inf?rm?tiv? f?r something ??u h?v? t? ?r???nt as a source ?f ?nt?rt?inm?nt to your vi?w?r?. In f??t it is not an ???? j?b, ??m? clubs and ???rt agencies ?r? mu?h ?tri?t and h?r?h upon sports n?w? ??r??n?. To ??rf?rm w?ll in ?u?h a ???n?ri? r?quir?? a high l?v?l ?f professionalism.

These ??rt?l?, ?h?nn?l? and ?rint media ?r? making high ?r?fit? from sports j?urn?li?m. Introduction of wealth ?nd a concept ?f ?r??tigi?u? r???gniti?n in sports h?v? m?d? ???rt? journalism as profitable bu?in???. H?w?v?r, fuss ?f ???rt n?w? agencies and their qu?ntit?tiv? approach has ?m?rg?d a ?tr?ng urg? ?f qualitative and much ?r?f???i?n?l sports j?urn?li?m.

Th?r? are lit?r?ll? th?u??nd? ?f ?l???? ?n th? w?b to g?t ??ur spor haberleri inf?rm?ti?n. Wh?th?r you w?nt th? l?t??t headlines, u? t? th? ????nd scores, editorials, ?r in d??th ?n?l??i?, th?r? are a m?ri?d ?f ?h?i??? f?r you. Whil? ??m? sites ?nl? ?ff?r ?n? ?r tw? ?f those thing?, th?r? ?r? ??v?r?l th?t ?ff?r all ?f th??? ?nd more.

5. Yahoo! Sports (???rt?.??h??.??m) – thi? ?it? i? ?ll ?ub?t?n?? and n? fl??h. It l??k? essentially th? ??m? ?? it did five ???r? ago. That’s not n??????ril? a b?d thing, it ju?t doesn’t knock your ???k? off. An? inf?rm?ti?n that ??u need i? r??dil? ?v?il?bl? ?nd u? to d?t?. C?lumni?t? aren’t ?? w?ll kn?wn as th? top ?it??, but they are solid.

4. FOX S??rt? (m?n.f?x???rt?.??m) – a f?w ???r? ?g? this ?it? was a m???. It was th? anti-Yahoo! – ?ll fl??h and no ?ub?t?n??. In the past f?w years th??’v? t?n?d down th? fl??h ?nd increased th? ?ub?t?n??. The live g?m????t? ?t the t?? of the ??g? ?r? ?xtr?m?l? innovative. F?r ?x?m?l?, for a baseball g?m? ??u not only see the ???r?, but also an ?v?rvi?w ?f th? diamond and wh?t runn?r? are ?n base. If ??u ?r? int?r??t?d in a ????ifi? g?m? ??u ??n r?ll ??ur m?u?? over it and g?t m?r? details. If FOX k???? inn?v?ting lik? that, th?? w?n’t b? number 4 f?r l?ng.

3. Sports Illustrated (???rt?illu?tr?t?d.?nn.??m) – thi? ?it? ?x??l? in tw? things – ?dit?ri?l? ?nd rum?r?. Th?? h?v? THE b??t writ?r? (th?? ?r? Sports Illu?tr?t?d after ?ll) and th?? d? an ?x??ll?nt job ?f ?r?viding t?n? ?f ??nt?nt. Peter King’? Monday M?rning Qu?rt?rb??k ??lumn is absolutely ?ri??l???. Th?? ?l?? ??m?il? a ‘Truth and Rum?r?’ section f?r ???h of th? m?j?r ???rt?. It’? essentially a compilation ?f ?ll ?f th? rum?r? fr?m l???l newspapers across the country. Th? b??t ??rt about it i? it’? fr??, unlike ESPN’? rumors.

2. CBS S??rt?Lin? (?b?.???rt?lin?.??m) – ?v?r?thing i? gr??t ?b?ut S??rt?Lin? – they ?r? ?ft?n the fir?t to break n?w?, gamecasts ?r? innovative ?nd ?ff??tiv?, ?nd f?r what it’s worth the f?nt??? ???rt? ?r? th? best ?n the w?b. W?ll, they ?r? great at everything except ?dit?ri?l? ?nd ?n?l??i?, and th?? ?r? h?rribl? ?t th?t. T?n? Mejia, D?nni? Dodd, P?t? Prisco, ?nd Greg D??l? are th? w?r?t group of ???rt? writ?r? ?n the w?b. Wh?r? ?r? th? ?dit?ri?l? from their on-air personalities lik? Jim N?ntz and Bill? P??k?r? ESPN and FOX m?n?g? t? get their ?n-?ir ??r??n?liti?? t? writ?, m??b? CBS ?h?uld ??n?id?r it. R??d the comments at the b?tt?m ?f ?n? ?rti?l? b? ?n? ?f th? aforementioned writ?r? ?nd ??u’ll r??liz? th?t I’m n?t the ?nl? ?n? th?t think? they ?r? horrible.

1. ESPN (www.???n.??m) – th?? ?r? ??n?i?t?ntl? ?h??d ?f th? ?urv? in every ?n? ?f the im??rt?nt ?????t?. They ?r? the w?rldwid? l??d?r in ???rt? ?nd they ?h?w n? ?ign? ?f giving u? that ?r?wn ?n the web. I commend th?m f?r getting th?ir b??t ??r??n?liti?? – John Cl??t?n, St?v?n A. Smith, B?rr? M?lr???, ?nd Peter G?mm?n? – to writ? consistently good articles. The only downside i? that t?? mu?h inf?rm?ti?n is hidden in th? ‘Insider’, ESPN’? ??id ??rvi??. It’? fru?tr?ting to r??d a h??dlin?, ?li?k, and then r??liz? th?t you can’t read th? ?t?r? because you have t? ??? f?r it.

Spor Haberleri (aka Son Dakika Spor Haberleri) is the name who writes this article for people as a free, informative and helpful publication.

Taekwondo One of the best defensive sport for kids

In 1952, there was a martial art demonstration, in which martial art participants showed their skills and movements. On one occasion, Nam Tai Hi broke 13 tiles with a single punch. The then President of South Korea initiated the reintroduction of martial art skills in the army. The name -Taekwondo- was submitted and accepted in April 1955. There were nine Kwan (taekwondo practitioners) at that time and all these agreed to the same code of conduct and KTA (Korea Taekwondo Association) was established in 1960. After that, masters of taekwondo were sent to different part of the world to teach people all the techniques and rules of Taekwondo. These efforts to grow the sport have led to the widespread popularity of martial arts throughout the world. The ITF (International Taekwondo Federation) was established in 1966 and the WTF (World Taekwondo Federation) was established in 1973. Taekwondo was a demonstration sport in the 1988 Olympics and then became a full Olympic sport with medals during the Sydney 2000 Olympics. The Common Wealth Games also added taekwondo in 2010. Taekwondo is not only a sport. It is a lifestyle, that improves fitness, tolerance and overall mental health. Quick movements with the hands and feet are practiced repetitively to build muscle memory and to enable the fighters to react in the quickest manner possible. The fitness level obtained with training for this sport is comparable to the most demanding Olympics sports. Taekwondo also provides an excellent level of confidence for the practitioner. The mental focus required to complete at an international level is as important as the athletes physical ability. Originally confined mostly to Asia, martial arts are practiced in almost every nook and corner of the world. The Olympics has helped Taekwondo to become mainstream and one of the most popular and fastest growing martial art. taekwondo videos olympic taekwondo

HYPONATRAEMIA IN ULTRA-ENDURANCE SPORT – WHO IS AT RISK

INTRODUCTION

Hyponatraemia by definition means low (hypo) sodium (Na) in the blood (emia), (Benardot, 2006). Mild hyponatraemia results from a serum sodium concentration below 135 mmol/L, while a serum sodium concentration below 125 mmol/L triggers severe hyponatraemia (McArdle, Katch & Katch, 2006). As serum sodium concentrations drop, fluid will leave the bloodstream by osmosis and accumulate in tissues, causing swelling i.e. cellular edema. If nerve cells swell too much they cease to function properly. Therefore, although cellular edema is well tolerated by many of the body’s tissues, it is not well tolerated by the brain (Smolin & Grosvenor, 2008; Dunford & Doyle, 2008). Consequently, the serious symptoms of hyponatraemia are mainly related to cerebral edema and include mild symptoms of headaches, confusion, nausea and cramping; to severe symptoms of seizures, coma, pulmonary edema, cardiac arrest and death (McArdle et al., 2006; Benardot, 2006). There are a number of speculated causes of hyponatraemia in athletes. One is known as the syndrome of inappropriate antidiuretic hormone response (SIADH) which causes decreased urine production and increased fluid retention during fluid overload. But by far the most common factor in hyponatraemia is excessive drinking (Murray, Stofan, & Eichner, 2003). Rates of occurrence vary from 0-0.4% of finishers in case-based publications, to as high as 1.3% of finishers in cohort study populations (Chorley, 2007). The reported incidence of hyponatraemia in ultra-endurance events lasting over 6 hours ranges from 0.3-27%. This incidence is even higher among athletes requiring medical attention, ranging from 9-60% (Hsieh, 2004). In a study of more than 18 000 ultra-endurance runners, approximately 9% of collapsed individuals presented with symptoms of hyponatraemia (Noakes et al., 1990, as cited by McArdle et al., 2005). Death is a rare occurrence with only nine cases reported worldwide since 1985 (Carter, 2008). However, there is still some debate in regards to some of the reported incidences, as some of these studies had incorporated biased subject selection into their methodologies. An example of this is the selection of subjects based on showing possible signs of hyponatraemia upon finishing their event, potentially leading to an overestimated population (Carter, 2008). The purpose of this literature review is to review recently published scientific research to evaluate the importance of the factors involved, and to possibly identify any further factors that may increase the risk of developing hyponatraemia. The strengths and weaknesses of the reviewed studies will be discussed, before conclusions are drawn and recommendations made to athletes on how to avoid or lessen the chance of developing hyponatraemia.

Relevance to Sports Nutrition An understanding of hyponatraemia for athletes and others involved in sport is important because many of the symptoms may be non-specific and similar to those of dehydration and other exercise-related illnesses, which may lead to inappropriate treatment. Near-deaths from hyponatraemia during the 1985 Comrades ultra-marathon prompted the subsequent establishment of field laboratories in the medical tents of some ultra-endurance events (Hsieh, 2004). Under normal circumstances, it is very difficult for a healthy individual to develop hyponatraemia through overzealous drinking and rarely occurs outside of the mental illness domain. This is due to the kidneys ability to process and excrete excess water as well as conserve sodium. However, during exercise, urine production is decreased by between 20-60% due to a decrease in kidney blood flow leading to a reduced capacity for fluid homeostasis and therefore an increased risk of developing hyponatraemia when combined with excessive fluid intake (Achinger, Moritz & Carlos Ayus, 2006; Murray, Stofan, & Eichner, 2003; McArdle, Katch & Katch, 2005). Regardless of the -true’ incidence rate, the fact remains that hyponatraemia is a fairly common occurrence in the domain of ultra-endurance athletic events and therefore deserves closer scrutiny as to how this incidence may be lowered, more easily recognised and treated more effectively.

SUMMARY OF THE REVIEWED LITERATURE

In 1996 the American College of Sports Medicine (ACSM) proposed guidelines that athletes should -drink as much as tolerable’ during exercise. This recommendation has possibly led to some athletes becoming over-zealous in their drinking habits. The most recent guidelines by the International Olympic Committee (IOC) urge athletes to drink enough to replace what is lost. This latest recommendation has received both criticism and praise with Noakes (2007) suggesting that both these guidelines lack an adequate, scientifically proven evidence base, and that they have not been properly evaluated in appropriately controlled, randomized, prospective clinical trials conducted in conditions that match the exercise. Many athletes may also suffer gastrointestinal distress if consuming the recommended amounts of fluid or aiming to replace fluid that is lost. On the other hand, the notion of aiming to replace all or most of the fluid that is lost has been supported by numerous studies and publications and it is argued that this is the most personalized approach to fluid intake and takes account of the athletes actual sweat loss which may vary with different environments and exercise intensities. Although it is important that during training athletes need to learn to approximate their sweat rate under various conditions in order to plan an effective drinking strategy as well as learn what is tolerable (Sallis, 2008; Murray, Stofan, & Eichner, 2003; Jeukendrup & Gleeson, 2004). In an article by Noakes (2007), six studies were reviewed that compared the effects of -some’ fluid replacement with full fluid replacement during exercise (Below et al., 1997; McConnell et al., 1997; McConnell et al., 1998; Daries et al., 2000; Backx et al., 2003; Dugas et al., unpublished, as cited by Noakes, 2007) and none of the studies showed that full replacement was advantageous over -some’ replacement. It was also suggested that all currently published evidence shows that hyponatraemia is caused by fluid overload while any acute sodium deficiency plays only a minor role. To avoid fluid overload, it was recommended that thirst be used as the mechanism to determine fluid consumption (Noakes, 2007). In a conference paper presented by Chorley (2007), risk factors for hyponatraemia that were consistently noted in all studies reviewed included high fluid intake, insufficient weight loss and slower finishing times. Other risk factors that may contribute included low and high body mass index, lighter pre-race weight, less Marathon experience, female gender, NSAID use and higher heat stress weather conditions. It was found that runners who fail to lose 0.75 kg throughout the duration of the event were seven times more likely to be hyponatraemic than those who lose more than 0.75 kg (Chorley, 2007). In a review article by Verbalis (2007) it was found that in virtually all studies where bodyweight has been recorded before and after exercise, there has been a consistent inverse relationship between bodyweight and serum sodium concentrations, indicating fluid retention. For example, data from the New Zealand Ironman triathlon in 1997 showed that the most severe cases of hyponatraemia occurred in athletes who had gained weight during the event. In studies that have quantified fluid intake, a significant negative correlation between ingested fluid volumes and serum sodium concentrations have been shown. The trend of net weight gain suggests that fluid ingestion often exceeds the sum of fluid loss from sweating and urination (Verbalis, 2007). In two case-control studies (Irving, Noakes & Buck, 1991; Speedy, Rogers & Noakes, 2000, as cited by Verbalis, 2007), athletes who developed hyponatraemia following ultra-marathon and ironman triathlon races were matched to a subset of non-hyponatraemic competitors. It was found that in the 9-24 hour period after the race, the hyponatraemic finishers excreted 1.3-3.0 L of fluid while the non-hyponatraemic finishers ingested 0.5-2.7 L, thus indicating the development of excess fluid retention throughout the race for the hyponatraemic finishers. Also, both groups had similar levels of sodium losses and sodium retention. It was concluded that these results supported the hypothesis that it is excess fluid retention that is the primary cause of hyponatraemia (Verbalis, 2007). It was also found that in most studies in which gender differences have been examined, the incidence and severity of hyponatraemia has been found to be greater in female athletes (Verbalis, 2007). In a consensus statement issued by 12 international experts on what is currently known about hyponatraemia, it was stated that excessive sodium loss did not appear to be a contributor to hyponatraemia, although it was acknowledged that more research was needed to track sodium losses in athletes with large sweat volumes related to warm climates (Schnirring, 2005). Risk factors that were highlighted were in agreement with trends noted by medical directors at endurance events. Avoiding sports drinks, sodium supplements, and salty food does not seem to be a risk factor for events lasting less than four hours (Schnirring, 2005). To prevent hyponatraemia, it was recommended that slower participants could either allow thirst to guide fluid consumption, or calculate individual sweat loss rates and use this to limit consumption (Schnirring, 2005). However, the former of the two suggestions has been criticised by numerous studies and publications which argue that using thirst as a guide will allow a greater degree of dehydration to occur, as quite often the feeling of thirst is not felt until a significant degree of dehydration has occurred. Dehydration has been shown to adversely affect exercise performance at levels of 2% loss of body weight or more (Jeukendrup & Gleeson, 2004; Murray, Stofan, & Eichner, 2003). Weschler (2005) conducted a mathematical analysis on data from previous studies. A high correlation was found between fluid overload and hyponatraemia. It was also noted that while over-hydrated event finishers with a serum sodium concentration of 128-130 mmol/L present with hyponatraemia, thus far dehydrated finishers with the same serum sodium concentration have not yet been observed with symptoms of hyponatraemia. This supports the hypothesis that serum sodium concentrations alone are not enough to cause swelling in the cerebral nerves; fluid overload must also be present. In a mathematical analysis of studies in which pre- and post-event bodyweights are known, it was shown that the more the athlete weighed at the end of the event relative to their weight at the start, the lower their serum sodium concentration. In an identical analysis but where fluid ingestion rates were known, the same relationship with serum sodium concentration was found. Also of interest, where no weight change occurs, serum sodium concentrations tended to be either low or normal. It was concluded that while over-drinking is the primary cause of hyponatraemia, sodium losses cannot be completely discounted, especially in longer events held in warm weather (Weschler, 2005). Sports drinks were not shown to protect against hyponatraemia if consumed to excess levels although when not consumed to excess levels, a sports drink containing sodium may significantly delay or prevent exertional hyponatraemia from occurring (Weschler, 2005; Carter, 2008). In a review article by Hsieh (2004), it was stated that guidelines for fluid intake have traditionally focused on the adverse effects of dehydration, with recommendations that fluid intake should exceed the sensation of thirst satiety. Some guidelines have recommended ingestion of fluids at a rate of 1L/hr, especially during hot weather events which is extremely generalized and non-specific to the many variables involved in endurance events and competitors. It was noted that this has resulted in some competitors over-compensating, and thus ingesting too much fluid in an effort to avoid dehydration and other heat-related illnesses. As a result, these competitors become overloaded with fluid and this, combined with inappropriate physiological responses of the body, leads to excessive retention of fluid and a danger of developing hyponatraemia. Hsieh (2004) was critical of the notion of drinking to replace losses in bodyweight. In a study by Rogers (1997) (as cited by Hsieh, 2004), it was found that fluid deficit only accounted for 40% of weight loss in ultra-marathon runners. This finding suggested that the use of weight changes may over-estimate the rate of fluid depletion. Hsieh (2004) also pointed out that while the intake of excessive amounts of hypotonic fluid has been linked to hyponatraemia, no cases of hyponatraemia have been reported in those that are dehydrated. A fluid intake of 500 mL/hr or less was suggested, especially for athletes performing at lower exercise intensities (Hsieh, 2004) although this figure seems far too generalized considering the many variables involved in athletes sweat rates, exercise intensities and environments. Hsieh (2004) also stated that calculations of the amount of sodium lost through sweat based on observed sweat content and volume in endurance athletes have not matched the hypothesised sweat sodium losses required to result in hyponatraemia. High sodium (57mg/100ml) replacement fluids may be poorly tolerated. Many commercial sports drinks are sufficiently dilute, although some are too dilute. Some athletes ingested salt tablets, although laboratory and field studies have not shown these to be effective in raising serum sodium concentrations (Hsieh, 2004). STRENGTHS AND WEAKNESSES OF THE REVIEWED STUDIES

In an article by Noakes (2007), the author criticises the ACSM and IOC fluid consumption guidelines because they lack an adequate, scientifically proven evidence base, and that they have not been properly evaluated in appropriately controlled, randomized, prospective clinical trials conducted in conditions that match the exercise. Yet it is unclear whether or not the six studies he reviewed met the same stringent criteria. In fact, one study has not even been published. Chorley (2007) likewise, quotes their own unpublished data to support their claims. Chorley discusses risk factors that are consistently noted in -all studies’, yet only offers seven stated references to support their discussion. Verbalis (2007) cites two case-control studies (Irving, Noakes & Buck, 1991; Speedy, Rogers & Noakes, 2000) where hyponatraemic athletes were matched with non-hyponatraemic athletes for comparison. Yet it is unclear how large the samples were, or whether or not the matching process overcame potentially confounding variables (such as age, bodyweight, level of training etc). Schnirring (2005) uses consensus statements not just from those in academia, but also from medical directors at endurance events. Weschler (2005) performed a mathematical review on up to 150 studies using the Nguyen-Kurtz equation. This equation has been refined and is solidly grounded in experimental observation, and is a best-fit equation with r=0.83 for serum sodium concentration and total body water.

CONCLUSION Regarding the risk factors for hyponatraemia: 1) Prolonged exercise in hot weather/climates. Numerous studies have suggested that higher heat stress due to weather conditions is a risk factor, especially during prolonged physical activity greater than four hours. Exercise intensity did not necessarily have to be high. All of the studies reviewed focused on marathon or ultra-marathon-type distances (Chorley, 2007; Schnirring, 2005; Hseih, 2004; Murray, Stofan & Eichner, 2003). 2) Poorly conditioned or acclimatized individuals who experience excessive sweat loss with high sodium concentrations. Athletes who have acclimatized well to their environment typically excrete less sodium in their sweat due to an improved capacity of the sweat glands to conserve sodium (Murray, Stofan & Eichner, 2003). Noakes (2007) suggests that acute sodium deficiency only plays a minor role in hyponatraemia. 3) Frequent intake of large quantities of sodium-free fluid during prolonged exercise. Numerous studies and publications have concluded that there is a consistent link between fluid overload and hyponatraemia. Some studies have also reported that thus far no dehydrated athletes have ever presented with hyponatraemia. Further studies have also commented that certain recommendations for athletes to replace lost fluids during events have led to over-consumption of ingested fluids and subsequent incidences of hyponatraemia (Noakes, 2007; Chorley, 2007; Verbalis, 2007; Weschler, 2005). Weschler (2005) stated that even beverages containing sodium can still lead to hyponatraemia if consumed in excess. 4) Use of diuretic medication. Chorley (2007) and Hseih (2004) identified use of non-steroidal anti-inflammatory drugs (NSAIDs) as a possible risk factor. NSAIDs such as aspirin or ibuprofen, or any other substances that causes a diuretic effect, such as some hypertension medications, may alter kidney function in a way that increases the risk of hyponatraemia during long-duration events (Benardot, 2006; McArdle et al., 2006). 5) Female gender. Numerous studies have highlighted and suggested that the female gender is a possible risk factor when linked with endurance exercise. Female athletes in general tend to be at higher risk for hyponatraemia because of their smaller body masses (Chorley, 2007; Schnirring 2005; Hseih 2004). In a study review by Murray, Stofan & Eichner (2003) the authors suggest that the higher incidence of hyponatraemia in females may be due to the female gender being more vigilant drinkers compared to their male counterparts as well as more likely to heed and possibly exceed advice from experts and coaches, or general advice such as -optimal hydration is beneficial for performance’ which is open to misinterpretation. The following additional risk factors were also highlighted in the reviewed studies: 6) Lower body mass. This is due to the fact that those with less body mass will have lower absolute fluid requirements and it will take less fluid to dilute the extra cellular fluid (Chorley, 2007; Schnirring, 2005; Murray, Stofan & Eichner, 2003). 7) Slower finishing times. This risk factor is linked to 1) and 3), because slower finishers are competing for longer, they have a longer amount of time to ingest more fluid (Chorley, 2007; Schnirring, 2005; Hseih, 2004). 8) Race inexperience. This risk factor is likely to be linked to 7), as slower finishers are more likely to be inexperienced and may also less knowledge of safe fluid intake practices (Schnirring, 2005).

Recommendations Athletes engaging in endurance events of greater than four hours duration should, if possible, compete in events held in cool weather conditions and if performing in hot conditions, acclimatization training would be beneficial. In events of more than four hours duration, a sports drink containing sodium will be beneficial. If thirst is used as an indicator of fluid intake this may potentially cause a loss in performance due to excessive dehydration. It would, in the authors opinion, be far more beneficial to create a fluid intake plan based on trialled strategies in training based on maintaining close to weight balance pre and post exercise and using amounts that the athlete can tolerate without negative side effects such as gastro-intestinal stress and discomfort. Athletes should experiment beforehand in training to determine their appropriate fluid intake and take into account and trial different exercise intensities and climates/environments in an effort to match race conditions. However, under no circumstances should they replace more fluid than what is lost. If hypotonic sports beverages containing sodium are to be ingested during the event, this should be done with the understanding that such beverages do not protect against hyponatraemia but may delay or prevent this occurrence when taken in adequate amounts. Any athlete taking medications that may alter kidney function, such as NSAIDs or diuretics, should consult with their doctor before undertaking any ultra-endurance event. Slower finishers, females and those with low body mass need to be aware that they may be at increased risk of hyponatraemia. Upon examining an athlete with hyponatraemia, blood pressure will be stable, as well as heart rate. A certain degree of confusion or altered consciousness may be noticed as well as puffiness when hyponatraemia is moderate to severe. Therefore, anyone involved in the evaluation of collapsed athletes at endurance events should assume hyponatraemia if the athlete shows signs of altered consciousness but other factors such as heart rate, blood pressure and temperature are normal (Sallis, 2008).

REFERENCES

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