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Drink lots of fluids

Dr. Drew Werner

EAGLE COUNTY – Dear Doc: I have a hard time getting my son to drink enough water. He is very active in sports and I think it might be causing other problems. What’s a mom to do?- Pushing water in EagleDear Pushing Water: For many people, consuming enough water is a real challenge. The longer someone goes inadequately hydrated, the more he or she gets used to it until they do not even recognize they are dehydrated. Water is our best fluid, but juices, sports drinks and others are better than nothing. Fluids with caffeine such as coffee, tea, colas and even Mountain Dew act as mild diuretics and not only do not help, they might make dehydration worse. The same is true with alcohol. While a cold beer might taste good on a hot day, it will not help hydrate us despite how “thirst quenching” it seems.Our bodies are made up of 55-65 percent water. Any less and we’re in big trouble. Dehydration is the excessive loss of our body’s normal water and electrolytes (think salts like sodium, potassium and chloride). Mild dehydration is the loss of no more than 5 percent of the body’s fluid. Loss of 5-10 percent is considered moderate dehydration. Severe dehydration (loss of 10-15 percent of body fluids) is a life-threatening condition that requires immediate medical care. Once we’re thirsty, we are already approaching 3-5 percent dehydration. It doesn’t take much more to rapidly put us in a tailspin.Assuming good health (no illness causing fluid loss like vomiting or diarrhea), there are many ways for us to get dehydrated. Routine or “sensible” fluid losses are obvious and easily measured when we go to the bathroom. Urinary losses account for about 1 quart of fluid a day and stool adds a bit more to that. That is how we eliminate toxins from our bodies. Insensible losses account for the rest. Our 2-4 million sweat glands cause 3 to 80 ounces of fluid loss per hour! That is directly affected by our level of activity, clothing we are wearing, outside temperature, humidity, and our level of physical conditioning.Why do we need water? All our organs need it to function optimally. Let’s look at several of these:– Our vascular system needs water to maintain adequate blood pressure, which gives oxygen to our tissues and carries away carbon dioxide and other toxins.– Our hearts need water to maintain a critical balance of sodium, potassium and other electrolytes, which keep it beating regularly.– Our lungs need water to exchange oxygen and carbon dioxide– Our brains need water to think clearly and allow us to send the signals that keep our muscles working.– Our skin needs water to keep us cool. Those 2-4 million sweat glands are the body’s radiator, using evaporation to cool us down. Take away blood flow to the skin and we quickly over heat, quickly causing our hearts, brains and kidneys to stop working.– Our kidneys need water to work properly. Severe dehydration can even cause kidney failure.– Like our kidneys, our intestines need plenty of water to work properly. We al know what a pain in the … it is if they don’t work well!To figure how much water we need, not counting excess losses through illness, exercise or medication, use this formula:1. Add 1 quart for the first 22 pounds of body weight.2. Add half a quart for the next 22 pounds of body weight.3. Add 6 ounces for each 22 pounds of body weight after that.A person weighing 180 pounds, for example, would require at least 85 ounces of water daily. All fluids count, except caffeinated and alcoholic beverages. Those add fluid, but then take some away through their diuretic properties, so the net gain is about half. We get fluids through the food we eat, as well, so subtract 10-20 percent for that. If you’re exercising or perspiring moderately to heavily, then use the above numbers as a minimum and add 20 to 50 percent. Another simpler way to estimate our water needs is to drink just a bit more in ounces than one half our weight in pounds (thanks again to Eliza Klearman, a naturopath who recently opened her practice in Edwards, for this simple tip).The American College of Sports Medicine recommends:1. Individuals consume a nutritionally balanced diet and drink adequate fluids during the 24-hour period before an event, especially during the period that includes the meal prior to exercise, to promote proper hydration before exercise or competition. 2. Individuals drink about 500 ml (about 17 ounces) of fluid about two hours before exercise to promote adequate hydration and allow time for excretion of excess ingested water. New information shows that excessive water drinking before exercise may actually cause electrolyte disturbances, so don’t over do it! 3. During exercise, one should start drinking early and at regular intervals in an attempt to consume fluids at a rate sufficient to replace all the water lost through sweating (i.e., body weight loss), or consume the maximal amount that can be tolerated. 4. Ingested fluids should be cooler than ambient temperature (between 15 degrees and 22 degrees C [59 degrees and 72 degrees F]) and flavored to enhance palatability and promote fluid replacement. Fluids should be readily available and served in containers that allow adequate volumes to be ingested with ease and with minimal interruption of exercise. 5. Addition of proper amounts of carbohydrates and/or electrolytes to a fluid replacement solution is recommended for exercise events of duration greater than one hour since it does not significantly impair water delivery to the body and may enhance performance. During exercise lasting less than one hour, there is little evidence of physiological or physical performance differences between consuming a carbohydrate-electrolyte drink and plain water. If someone you know just won’t drink enough, make it more fun. Have them pick a container they like. Keep it cold and if needed make it taste better by using juice or sports drinks.Remember your health is your responsibility! Health is our greatest asset and it doesn’t happen by accident. If something doesn’t seem right, or questions are left unanswered don’t wait, call your doctor.Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado


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