Collegiate Marching Band Artists Self-Report Previous Exercise-Associated Hyponatremia: A Cross-Sectional Study

Exercise-associated hyponatremia (EAH) is commonly observed in endurance athletes, where prolonged physical exertion combined with being unaware of personal hydration needs can lead to excessive water consumption or inadequate sodium intake. Marching band (MB) is an emerging setting for sports medicine professionals. However, there is little research on non-musculoskeletal illnesses among these performing artists. This study is part of a larger cross-sectional study and seeks to examine whether MB artists have previously experienced EAH and the presence of known EAH risk factors (e.g., pre-existing medical conditions, medication use, nutritional behaviors). Active collegiate MB members (n = 1207; mean age = 19.6 ± 1.3 years) completed an online survey that characterized demographics, medical history, and nutrition behaviors. Statistical analyses included descriptives (mean, standard deviation) and frequencies for all data. Binomial logistic regressions analyzed the relationship and determined the odds ratio (OR) between previous EAH and EAH risk factors. Participants were from 23 different states, predominately White (82.9%), female (56.7%), and at NCAA Division I institutions (92%). A total of 74 (6.1%) participants reported previously experiencing EAH, 32 (43.2%) within the past year. Previous EAH occurrence was greatest among individuals who had kidney conditions (χ²(1) = 5.920, R² = 0.013, OR = 15.708, p = 0.015); mood/neurological conditions (χ²(1) = 7.508, R² = 0.017, OR = 2.154, p = 0.006), particularly anxiety (χ²(1) = 7.651, R² = 0.017, OR = 3.590, p = 0.006); used mental health medications (χ²(1) = 7.512, R² = 0.017, OR = 2.220, p = 0.006), particularly selective serotonin reuptake inhibitors (χ²(1) = 13.502, R² = 0.030, OR = 3.297, p < 0.001); and who dieted (χ²(1) = 6.121, R² = 0.014, OR = 1.913, p = 0.013) or perceived they had an eating disorder (χ²(1) = 9.502, R² = 0.021, OR = 2.729, p = 0.002). Healthcare providers should be aware that MB artists may have pre-existing medication conditions, use medication, and have inadequate nutrition. Targeted hydration and nutritional education for MB artists is essential for effective prevention and early EAH recognition, improving health and performance for MB artists within demanding environments.