Our Greatest Wealth Is Health

Andrew Siegel MD 1/11/2020

Many 2020 New Year’s resolutions involve a healthier lifestyle with one component being improved hydration by drinking lots of water. Is this a good thing or merely hype? Today’s entry sets the record straight about hydration and disabuses some of the crazy notions concerning hydration perpetuated by dubious sources.

NY Times article by Catherine LeClair 1/4/2020 : Everyone’s Resolution Is to Drink More Water in 2020

Water—essential for life, calorie free, the ultimate thirst quencher and readily available with the turn of a faucet. The importance of water transcends its face value as a vital life necessity and assumes ritual and spiritual significance in terms of purification and ablution—think Native American rain dances, baptisms, mikvahs, etc.   

Let’s start off with some undisputed truths concerning hydration:

1. Drinking an adequate volume of water is vital to health and wellness.
2. Water promotes optimal organ and cellular functioning, temperature regulation, nutrient and waste transportation, joint lubrication, and facilitates the thousands of chemical reactions occurring within our bodies every minute.
3. Water accounts for 60% of body weight, two-thirds of which is within cells and one-third of which is in blood and the tissues between cells: For a 165 lb. man, that translates to 100 lb. of water weight; For a 125 lb. woman, that translates to 75 lb. of water weight.
4. Human bodies are remarkably well engineered and are designed to give proper feedback to maintain health with thirst calling for water consumption.
5. If adequately hydrated, one will not be thirsty and urine will appear dilute, similar to the color of light American beer.
6. Dehydration is marked by thirst, decreased urine output, and urine deeper in color, similar to the color of an amber, rich European beer.
7. Hydration can help prevent urinary infections, kidney stones and constipation.
8. Staying well hydrated can suppress hunger and help with weight loss, especially since thirst can often be confused or mistaken for hunger.
9. Water requirements vary dependent upon one’s weight, the ambient temperature and one’s level of physical activity, so blanket generalizations about how much to drink are meaningless for an individual.
10. Many foods have high water content and can be a significant source of water intake; generally, the healthier the diet (the more the fruit and veggie intake) the higher amount of dietary water.

And now for myths and falsehoods concerning hydration:

1. You must drink 8-12 glasses of water a day.
2. If you feel thirsty, you are already dehydrated.
3. Water cures sluggishness.
4. Water cures wrinkles.
5. Water cures headaches.
6. Water cures digestive problems.
7. Water cures dry skin.
8. Water is the anti-aging potion.
9. Water cures all of life’s woes.

Now, for some real problems that can occur from over-enthusiastic hydration:

1. Urinary urgency, frequency and even leakage (incontinence)—over consumption of water is a common cause of these urinary symptoms that lead many patients to the urologist’s office.
2. Water intoxication: Over consumption of water can lower serum sodium that can lead to a host of medical issues including mental status changes, seizures and coma.

You know that you are drinking too much water if:

1. You never leave home without a water bottle and always have one in your hand.
2. You drink water even when not thirsty.
3. Your urine looks as clear as water.
4. You have disturbing urinary urgency and frequency and perhaps cannot get to the bathroom on time to prevent accidental leakage.

When I was a child, there was no such thing as bottled water.  At home we drank from the tap and at school from the water fountain… Then emerged bottled water as an option to replace tap water. Thereafter, bottled water morphed into high-end refreshment beverages with brands such as Perrier mineral water and Evian natural spring water.  Ultimately, the high-end water products became increasingly chic: Voss artesian water, Fiji natural artesian water, Volvic natural spring water, San Pelligrino sparkling natural mineral water, etc. What a business! Nowadays all of the beverage companies are on board with the extremely lucrative water business and presently it has become hip, cool, and trendy to walk around with a water bottle–preferably not an environment-harming plastic one–and sip away, maintaining an impressive state of hydration.

Fortunately, dehydration is a rare, albeit serious phenomenon.  It has happened to me on several occasions, once when cycling for more than 50 miles on hilly roads in extreme heat and humidity.  My drinking simply could not keep up with my water losses through sweating.  I drank to the extent that water audibly sloshed around in my stomach, yet still I felt weak, fatigued, woozy, achy, and developed a nasty headache and confusion (dehydrated brain). Bright lights disturbed me and my vision was compromised (dehydrated eyeballs). I ended up recovering by lying on a couch for many hours and drinking copiously and gradually recovered.  It was not a good experience! Fortunately, I did not suffer the most severe complication of dehydration–heat stroke, a medical condition that demands emergent management and fluid resuscitation.  Children and the elderly are most at risk for the occurrence of dehydration.

The formula that doctors use for figuring out daily fluid requirements—especially useful for hospitalized patients not eating or drinking who depend totally on intravenous fluids—is: 1500cc (50 ounces) for the first 20 kg (44 lb.) of weight, and an additional 200cc (7 ounces) for each additional 10 kg (22 lb.) of weight.  So, for a 125 lb. woman the daily fluid requirement is 2250 cc (75 ounces).  For a 165 lb. man, the daily requirement is 2600 cc (87 ounces).  It is vital to understand that the 75-ounce of fluid requirement for the woman and the 87-ounce fluid requirement for the man includes both beverages and food. If one has a very healthy diet with lots of fruits and vegetables, there will obviously be less need for drinking water and other beverages.

So, how much to drink?

If you are sedentary and in a cool environment, your water requirements are significantly less than someone exercising vigorously in 90-degree temperatures.

Humans are extraordinarily sophisticated and well-engineered “machines” and our bodies let us know when you are hungry, ill, sleepy, thirsty, etc.  Heeding one’s thirst is one of the best ways of maintaining good hydration status. Another method is to pay attention to one’s urine color.  Depending on hydration status, urine color can vary from deep amber to as clear as water.  Dark amber urine often indicates the need to drink more water; a lighter color is ideal and indicative of satisfactory hydration, but urine does not need to look like water.

Bottom Line: 8-12 glasses of water daily: wacky under most circumstances!

Wishing you the best of health,

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

Prostate Cancer 20/20 on Apple iBooks

PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX 

Tags: Andrew Siegel MD, dehydration, hydration, overactive bladder, thirst, urine color, water consumption

This entry was posted on January 11, 2020 at 6:28 AM and is filed under health and wellness. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.