He was also among the fastest runners finishing within 582 min (9 h 42 min). This result is not in line with our and other findings that a high fluid intake is correlated with lower post-race plasma [Na+] [17, 19–21]. Possible explanations for this subject developing EAH could be other factors than excessive fluid consumption such as non-osmotic stimulation of arginine vasopressin (AVP) [31] or inability to mobilize osmotically inactive sodium from internal stores or inappropriate osmotic inactivation of circulating Na+ [20]. Other possible reasons could be a loss of sodium. A loss of sodium could occur click here via urine if AVP had been present, or by sweat, or by some combination of these.

Finally, we found that the change in the foot volume was significantly and negatively related to the change in plasma [Na+]. As fluid intake was associated with Crenigacestat mw the change in the foot volume, an increased fluid intake generally led to both a decrease in plasma [Na+] and an GSK2879552 increase in the foot volume. Obviously, slower runners were drinking more and their post-race plasma [Na+] tended to decrease, since both fluid intake and the change in the feet volume was significantly and negatively related to running speed. In addition, slower runners showed an increase in the foot volume. Presumably, slower

runners were sweating less and drinking at a higher rate than were the faster runners. As slower runners are more likely to overconsume fluids

[26] and excessive fluid consumption is the main risk factor for EAH [19–21], we infer that fluid overload occurred in the slower runners. Thus, fluid overload due to increased drinking behaviour seems to be the most likely reason for the development of peripheral oedemas leading to an increase in the foot volume in the present runners. A further finding was that the change in body mass was significantly and negatively related to running speed, where faster runners were losing more body mass. Similar findings reported Lebus et al. [44] for 161-km ultra-marathoners and Kao et Beta adrenergic receptor kinase al. [10] for 24-hour ultra-marathoners, where a greater body mass loss was associated with a better performance. Furthermore, Sharwood et al. [22] demonstrated that Ironman triathletes showing the greatest changes in body mass were among the fastest finishers. Our finding allows us to support the suggestion [10] that maintenance in body mass is not crucial to performance in ultra-endurance races. Thus, there was no evidence in our study that an increased loss in body mass impaired performance. We were measuring the feet volume using plethysmography. The same method used Bracher et al. [32] for measuring the volumes of both the lower leg and arm in ultra-marathoners. This method using plethysmography is similar to the method from Lund-Johansen et al. [46] measuring the leg volume by using water displacement volumetry. Lund-Johansen et al.