California Department of Consumer Affairs. (2016, December 21). California State Athletic Commission. Severe weight cutting and dehydration by Dr. Edmund Ayoub – 2 of 3. [Video]. YouTube. https://www.youtube.com/watch?v=Pl-8oJc_FD0&list=PLAGnBcgB9ibuAuj4U1Cjiwzw46AJvEjJm&index=1

Duration: 9:13

Transcript:

Spoken by Dr. Edmund Ayoub, Jr.: I am Dr. Edmund Ayoub, Jr. I reside in Palm Springs, California, where I have my medical practice. I’ve been a ringside physician for many years.

Written text: Why is it important to avoid severe dehydration when working to make weight?

Spoken by Dr. Edmund Ayoub, Jr.: Dehydration, being lack of fluid in your vascular system, has nothing but deleterious effects and deleterious effects on many organ systems: Your brain, your heart, your kidneys, your nutrient system, your muscles. The byproducts of dehydration can cause permanent and lasting effects.

Written text: How much is a safe amount of weight to cut per week/day? 

Spoken by Dr. Edmund Ayoub, Jr.: It has been a lifelong issue in combative sports, and sports of all types. Making weight is a requirement in combative sports like boxing and mixed martial arts. There is a misconception, I believe, that if you weigh one weight and you try to cut weight to fight at a lower weight class that you will be stronger than the people who would be naturally in that weight class. So, people try all kinds of methods, whether it be dieting, or whether it be sweating, or with pharmaceuticals in order to lose weight to get to a point where they can weigh in at a particular level, and then let themselves put on weight over the next 24 hours figuring that they will rehydrate and then be able to fight at a much higher weight, but having weighed in at a much lower weight. The problem with that is the deleterious effects that I had spoken about before that come about when you have severe dehydration.

A safe amount of weight to lose would be approximately 1 or 2% of your body weight per week. So a 200 lbs man, that would be 2 to 4 pounds per week for however many weeks your trying to lose. But that likely will keep the average person from becoming dehydrated from the weight loss.

Written text: What is severe dehydration?

Spoken by Dr. Edmund Ayoub, Jr.: Severe dehydration is when dehydration causes signs and symptoms and pathological problems to the human body, mainly to organ systems in the body. Severe dehydration can cause arrhythmias in the heart, it can cause lactic acid build up in the muscles, it can cause an increase in potassium from the breakdown of muscle cells in the body, it can cause a breakdown of muscle cells that causes severe proteinuria, which would be protein not being able to be filtered by your kidneys, and cause severe and even permanent kidney damage and kidney failure.

Written text: What problems can arise from becoming severely dehydrated?

Spoken by Dr. Edmund Ayoub, Jr.: Dehydration will cause a lack of blood volume. A lack of blood volume will cause a lack of blood flow in the body. A lack of blood flow in the body will cause decrease blood volume and oxygenation to the organs in the body. One of the major problems with dehydration is, again, lack of blood flow. Your brain gets less blood; your kidneys get less blood; your heart gets less blood; your muscles get less blood. The blood carries the oxygen that all of those organs and organ systems need to survive. With less blood you have less oxygen; and then you have poor performance from those organs. This can cause less volume in the brain, so if you imagine your brain being a potato inside jello filling a cavern, and then you take some of the jello out, as you move your head around, that potato will bang against the wall. Your brain, being that potato, is then more susceptible to bruising, which, in turn, is bleeding in the brain causing neurological trauma – whether it be transient neurological trauma or down the road from chronic dehydration efforts, it can be permanent neurological trauma. As far as your heart goes, you have less blood flow in your heart, so you have less output when your heart is beating and pushing less blood through. Then you have what we call low cardiac output and gives you a higher risk for developing cardiac problems. With less blood flow to the muscles, you have the break down of muscle fibers. The break down of muscle fibers causes two things. One, muscle fibers break down into protein, and it dumps protein into your blood stream, which is very difficult for your kidneys to filter, and many people with chronic dehydration efforts develop chronic kidney disease. The kidneys can no longer function correctly because they get gunked up because of the amount of protein that is not being filtered by damaged kidneys. The other thing that a breakdown of muscle cells causes is a release of potassium. Potassium is a major electrolyte in the cells, and when the cells break down, the potassium gets released into the blood. Well potassium is one of the main metabolites that controls the electrical function of your heart. One of the big concerns of a high potassium level would be a heart attack. Certainly arrhythmias, abnormal heartbeats, the severest of the abnormal heartbeats being the ventricular fibrillation, where you have a heart attack.

Written text: Is IV hydration superior to oral hydration?

Spoken by Dr. Edmund Ayoub, Jr.: Lots of studies have been done on this. IV hydration is faster than oral hydration. The difference being that oral hydration will satisfy your body and your brain’s need to quench your thirst, whereas IV hydration won’t quench your thirst, but IV hydration is a much faster way to hydrate, where someone who gets to a severe dehydrated state can rehydrate with approximately four bags of IV fluid – each bag being one liter. It will take approximately 48 hours to rehydrate orally, although you will satiate your body more with oral hydration. In the end, once you’re hydrated, there is no difference in performance from IV hydration versus oral hydration.

Written text: Does drastic weight cutting relate to performance?

Spoken by Dr. Edmund Ayoub, Jr.: In a dehydrated state, your performance, because of the break down of the muscle cells, the breakdown of the kidneys, the heart damage, and the brain dysfunction, will make a fighter dramatically less apt to perform at his or her peak level if they weren’t dehydrated. The studies in the NHL, NFL, and world soccer organization have all shown that performance in a dehydrated state is exponentially less than performance in a non-dehydrated state.

Written text: Does dehydration relate to neurological health?

Spoken by Dr. Edmund Ayoub, Jr.: Dehydration will cause less volume within the skull of the human athlete. So the brain, which sits in this bath of fluid, will have less fluid. When a fighter, either in mixed martial arts or boxing, gets punched, the brain moves to the front of the head where the punch was thrown, and then, as a rebound mechanism, falls back to the back of the head. So you get a bruise in the front of the brain and a bruise in the back. Imagine that with a full head of water. Now imagine taking some of that water out and throwing the same punch. The brain hits much harder in the front with less resistance from the water, and much harder in the rebound hit. So, the force of the injury of the combative sport – whichever one it is – is much greater on a dehydrated brain.