MC provided the supplements. All authors read and approved the final manuscript.”
“Background For more than 30 years, scientists have investigated and described the development of peripheral oedemata in endurance athletes. In 1979, Williams et al. studied the effect of seven consecutive days of hill-walking SP600125 mouse on both water balance and water distribution in five subjects who were allowed to drink water ad libitum[1]. They described

a retention of plasma sodium (Na+) and a reduction in packed cell volume and interpreted these findings as a movement of water from the intracellular to the extracellular space and therefore an expansion of the extracellular volume, leading to visible facial and ankle oedemata. Milledge et al. conducted in 1982 a similar study where they investigated five male athletes participating in an endurance exercise of five consecutive days of hill-walking [2]. They also described a retention of both plasma Na+ and water and a reduction in packed cell

volume. Furthermore, they reported that their athletes developed oedemata at the lower leg and supported therefore the conclusion of Williams et al. of a movement of water from the intracellular to the extracellular space, leading to an expansion of the extracellular volume and thus leading to peripheral oedemata [1]. In 1999, Fellmann et al. investigated whether a chronic click here expansion of extracellular water, usually observed during prolonged endurance exercise, was associated with an Berzosertib datasheet increase in intracellular water space [3]. In contrast to Williams et

al.[1] and Milledge et al.[2], they observed no decrease in intracellular water space while the extracellular water space increased while investigating nine athletes participating in a seven-day endurance race. Total body water, extracellular water and intracellular water space before, within and after the race were Cyclin-dependent kinase 3 measured. They concluded that a prolonged and repeated endurance exercise induced a chronic hyperhydration at both extracellular and intracellular levels, which was related to exercise intensity. Nevertheless, they confirmed that Na+ retention was the major factor in the increase of plasma volume. In 2010, Knechtle et al.[4] investigated the association between fluid intake and the prevalence of exercise-associated hyponatremia (EAH) in 11 female ultra-runners during a 100-km ultra-marathon. These athletes were told to drink ad libitum. Serum [Na+ and total body water remained unchanged despite a loss in body mass. For male 100-km ultra-marathoners, however, a decrease in body mass with a concomitant loss of both skeletal muscle mass and fat mass as well as with an increase of total body water was reported [5]. It was assumed that the increase in total body water might lead to peripheral oedemata.