IV in a bottle

In the summer of 2007, Dr. Benjamin Yoo kept seeing athletes from Charleston

Southern University coming into the Health First Rapid Care facility in North Charleston with symptoms of dehydration.

He'd get them hooked up to an IV bag, and they get over their symptoms, cramps or headaches within an hour.

Then the proverbial light bulb went off in his head.

"I got the idea, 'Why isn't there an oral drink as effective as a normal saline bag?' " says Yoo, who was born in Korea and grew up on his parents' farm in western Kentucky.

"Sodium is the key to rehydration. In my opinion, it's not potassium, magnesium or calcium, it's the sodium. When you sweat, you are sweating out salt and water. So sodium is the most abundant electrolyte outside your cells. Potassium is the most abundant inside your cells. When you are sweating, it's salt and water."

Yoo says consuming a salty fluid staves off dehydration, which can cause symptoms such as headaches, cramps, nausea, dizziness, fever and even seizures and coma.

In January 2008, BANa water was born.

The name BANa is partly derived from the nickname "banana bag" for a IV bag that includes multivitamins, which turns it yellow, and is typically ordered for alcoholic patients who come into emergency rooms for treatment of dehydration. BANa also plays off the abbreviation "Na" for sodium on the periodic chart.

Drinking salt water

After two years of getting BANa going, Yoo is ready for the big debut this year, and he's working into events such as last month's Cooper River Bridge Run, this week's Family Circle Cup tennis tournament (for players) and other athletic events.

But Yoo sees the drink application going beyond athletes. He has been working to have laborers, the severely sick and even binge drinkers try out the beverage.

In Yoo's opinion and experience, sodium chloride is the most important electrolyte, and BANa is all about the salt. In a 500 milliliter (16.9 fluid ounces) bottle, the adult formula has 800 milligrams of sodium, or 33 percent of the recommended daily allowance, and the children's version has 600 milligrams of sodium.

By comparison, the adult version has four times the amount of sodium as Gatorade, and the kids version has 82 more milligrams of sodium than Pedialyte.

That was about the limit that Yoo thought people

could tolerate taste-wise. And yet, for a public whose taste buds have been biased toward sweet drinks, it's still too salty.

"That's our main obstacle," admits Yoo, adding that a new citrus-flavored version does a better job of complementing the salty taste. "It is salt water because the concept behind it is an IV bag, which has 3.4 grams of sodium per liter of fluid."

Salt and carbs

In a culture where the medical profession tends to be concerned about overconsumption of salt, how can BANa be healthy?

Stacy Renouf, a registered dietitian at the Medical University of South Carolina who works closely with sports medicine, was not familiar with BANa initially, but after looking at its nutritional profile, says that the drink shouldn't be consumed by a recreational athlete or someone working in an air-conditioned environment.

"Realistically, the electrolyte levels would only be appropriate for an athlete who is sweating heavily (intense exercise in the heat) or someone with severe diarrhea. The concentration exceeds the typical recommendations for sodium replacement for most people," says Renouf, noting that the American College of Sports Medicine, National Athletic Trainers Association and USA Track and Field all recommend in the range of 250-350 milligrams per 500 milliliters of fluid.

"If I were to recommend this to anyone, it would be to athletes exercising in the heat and humidity for at least an hour or someone working outside doing physical labor for prolonged periods (four or more hours)."

Renouf says people on a salt-restricted diet, such as those with high blood pressure, should not drink BANa because of the salt content. If they are in a situation where they are sweating profusely, a lower-sodium electrolyte drink would be suitable. Regardless, they should consult their physician for advice on using electrolyte drinks.

She noted, too, that because BANa has no calories and only 1 gram of carbohydrate, athletes in endurance events should be seeking a source of carbohydrate replacement. BANa would have to be consumed in conjunction with food, such as an energy gel or bar.

IV without the needle

In making a full circle, one of the main beneficiaries of BANa so far has been the athletes at CSU.

Head athletic trainer Toby Harkins says the school uses it to prehydrate and rehydrate athletes and is using less Gatorade.

"In Charleston, South Carolina, it's hard to find stuff to help kids not cramp. In the past year, we have only done two IVs, and that's unheard of," says Harkins. "We use it for every sport and religiously for football. Women's basketball uses it a lot. ...We've had great success with it."

Harkins adds that out of an average of about 20 kids, only one tends to find it too salty to drink.

Fritz Von Kolnitz, a fishing guide, has found a way around the salty taste. He adds a packet of Crystal Light lemonade to it.

Ever since Von Kolnitz started being a fishing guide, which often requires him to be on the water for 12 to 15 hours a day in the summertime, he would have severe leg cramps at night. At the suggestion of Yoo, a friend of his girlfriend, he started drinking BANa three times a day when he's doing trips: once in the morning, once at lunch and once in the evening.

"I don't get leg cramps anymore," says Von Kolnitz, who admits that he does not like to drink water and that staying well-hydrated by drinking a lot of water has one side effect that doesn't go over very well with clients: the need to urinate a lot.

Von Kolnitz has another use for BANa.

"If I know I'm going to a wedding reception where I may drink a lot, I'll drink a BANa before going out and I'll wake up the next morning feeling fine."

Reach David Quick at 937-5516 or dquick@postand courier.com.

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