Drink More . . . Water?

Thirsty yet? That’s your body sending you a message. Summer means outdoor fun, construction work, heat, thirst, and . . . dehydration. Most of us are more aware during the summer of the need to maintain body fluids, but we can still get into trouble without noticing. First, a word about the benefits of proper hydration and then some suggestions on how to cope.

Our Bodies and Water

Water comprises approximately 60% of our total body weight (within a range of 45-75%) and is vital for proper functioning of all bodily organs and tissues. Some of the more important benefits include

·      Cushioning our joints and keeping them lubricated

·      Maintaining body temperature within tolerable limits

·      Eliminating waste through urine, bowel movements, and sweat

·      Improving kidney function

·      Preventing constipation

·      Maintaining healthy skin

·      Improving energy level and mental functioning

To obtain these and other benefits, we must maintain a proper balance between total fluid intake from all sources and fluid outflow through urination, sweating, breathing, bowel movements, metabolic processes, and evaporation. If fluid intake does not keep up with outflow to a serious degree, dehydration occurs which can result in mental confusion, muscular weakness, overheating, seizure, coma, and death—depending on severity.

Remember that we acquire water for our bodies from several sources, including fluids that we drink as well as fruits and vegetables that we eat. That means that the common advice for adults to drink eight 8-ounce glasses of water a day need not be rigidly followed. In fact, there is no clear scientific evidence to support such advice.

The trick is to consume a sufficient amount of fluids from all sources to offset the elimination of fluids. Obviously, maintaining that balance and avoiding dehydration depends on several factors: the external temperature of our environment, the intensity and duration of exercise, our general state of health (meaning an absence of fever, diarrhea, urinary tract infection, etc.), and the type of fluids that we consume.

Warning: It is possible to drink too much water under certain conditions. Doing so can lead to severe consequences. Athletes and others who engage in intense, prolonged exercise can create a situation of dangerously low sodium and electrolytes by drinking too much plain water too quickly. Such a deficiency causes a condition called hyponatremia. This condition causes headache, fatigue, nausea, vomiting, frequent urination, mental confusion, and several known cases of death. To prevent hyponatremia, persons who exercise intensely for a long time should drink a beverage such as Gatorade™ or Powerade™ that replaces sodium and electrolytes. Moreover, if too much fluid is consumed too quickly, the body’s cells become overloaded with water—a particularly dangerous situation when neurons in the brain swell where there is no room. (For a good discussion of hyponatremia, see “Strange but True: Drinking Too Much Water Can Kill” in Scientific American.)


What to Drink?


The best answer to that question is water. Under most conditions (see warning about hyponatremia above), water is the most efficient beverage for maintaining hydration without unwanted or unhealthy side effects. Even with water, however, there are some things to bear in mind.


While most municipal water is safe to drink, current water treatment systems are not designed to remove all impurities or contaminants. If your home is supplied by a municipal or regional water system, check the annual quality report for a list of what is or is not removed during the treatment process. As in the case of Flint, Michigan, and other cities, even lead has remained in the water supply at harmful levels. Municipal water treatment sometimes adds a large amount of chlorine, which some people find objectionable.

If you live in a rural or suburban area where you obtain your water from a ground well, you need to be especially careful about making sure that harmful contaminants are not present. Nearby industrial pollution, farm runoff, and shallow water tables can pose significant hazards. Get your well water tested regularly.

For these reasons, many people have turned to filtered or bottled water for drinking and cooking. Most bottled water is safe, but some have estimated that 40% of bottled waters are simply packaged tap water. Further, the FDA regulates bottled water as a food, but it lacks the monitoring capacity of the EPA to check on public water systems. Always check to see if your bottled water is filtered. Many bottled waters also contain artificial sweeteners or other ingredients to enhance taste. If you prefer a flavored water, try adding your own squirt of lemon or lime juice.

Water filtration systems come in many sizes and formats. No single system will remove all contaminants, and all need to be maintained so that contaminants don’t build up in the system. Usually reverse-osmosis filters, when combined with carbon filters, will remove heavy metals (arsenic, lead, mercury), bacterial contaminants, and residue from pesticides most effectively. But prices and effectiveness of different types can vary widely. Check the Environmental Working Group’s buying guide for additional information on water filters.


Although clean, safe water is best for staying hydrated, many of us prefer a little variety in what we drink. So what about the other alternatives?

Fruit Juice.

Always a favorite with kids, fruit juice can be a welcome alternative. Many commercial fruit juices are fortified with extra vitamins and some minerals. But most popular fruit juices—orange, apple, cranberry—contain high concentrations of sugar, either naturally or, in many cases, added. High amounts of sugar in any form are harmful for both children and adults, leading to various chronic conditions such as type-2 diabetes. Therefore, monitor consumption of fruit juices closely for sugar content, and drink them in moderation, not as a routine alternative to water.


By the way, commercial vegetable juices often contain high concentrations of sodium that can also be harmful. Read labels!


Tea and coffee are popular alternatives to water around the world. Most are available in caffeinated and decaffeinated forms. While there is some controversy over whether caffeine is beneficial, most studies show that there are some benefits to moderate consumption of caffeine—say, the amount found in about 1-3 cups of coffee or tea per day. Some people, however, cannot tolerate caffeine, even the minute amounts remaining in decaffeinated coffee or tea. Many herbal teas naturally contain no caffeine and, therefore, offer a pleasant alternative to plain water.


When considering variations on coffee or tea, such as those containing cream or sugar, remember that you are adding calories and sugar to your daily intake. Be careful!


Commercially available smoothies are delicious! Especially on a hot day, they can be very refreshing. But remember that they nearly always come loaded with sugar from both the fruit juices (see above) and the ice cream in them. You’re always better off preparing your own smoothies at home where you can control exactly what goes into them.


Vegetable smoothies made at home are a good alternative, but don’t overdue the sodium or sugar for them.


Americans consume billions of dollars’ worth of soda every year, and it is disastrous for their health. Soda is the largest contributor of sugar to the American diet, and that amount of sugar is creating an epidemic of obesity and related health problems from heart disease to diabetes. We are paying a very steep price in terms of poor health and money for our addiction to sugar.

Artificially sweetened soda does not help. The long-term effects of many artificial sweeteners have not yet been determined. Moreover, it now appears that they alter brain chemistry in a way that causes the body to crave additional intake of calories to match the sensation usually caused by sugar. In other words, artificially sweetened soda causes people to eat more and thereby leads to increased obesity.

Bottom line: if soda is your main beverage of choice, try to cut back or eliminate it altogether. This recommendation is especially important for children’s health as well.


A cold beer on a hot day, a glass of wine with dinner, or a cocktail at the end of the day can be very appealing. For most people and taken in moderation, alcoholic beverages can be a pleasant diversion. Some studies claim that a glass of red wine or a cocktail can carry some health benefits. But alcohol also introduces some genuine risks:

·      Mental or physical impairment, even when consumed in moderation

·      Addiction (alcoholism)

·      Ill effects on specific organs such as the liver

·      Unwanted increase in sugar intake (all alcohol converts to sugar)

·      Mild increase in dehydration due to increased elimination of fluids from the body

Such risks make alcoholic drinks a poor alternative to other beverages, especially in order to maintain hydration.

A Word about Containers

Most people are now aware that they should avoid plastic bottles that contain BPA (bisphenol A). Many countries now ban BPA, and manufacturers increasingly avoid using it. Do not purchase plastic bottles that do not contain a BPA-free label. Other chemicals used in the production of plastics such as PET (polyethylene terephthalate) might also be harmful by imitating the effects of estrogen.

While you should avoid plastics containing these compounds, you must also avoid reusing most plastic bottles. The reason is that reuse increases the likelihood of leaching harmful chemicals into whatever liquid the bottle contains. Rule: use your plastic beverage bottle once and then recycle it.


The safest beverage containers are made of glass or stainless steel. Glass is inert and is safe for nearly any beverage. Stainless steel, especially “food-grade” stainless steel, is also safe. In the case of stainless steel water bottles, however, be sure that any lining is glass, not plastic.


Maintaining proper hydration is vital for your mental and physical well-being. If you are thirsty, pay attention and drink something.

Dehydration, on the other hand, can be debilitating and even dangerous. If you or someone else becomes dehydrated, be sure to provide water for them to drink slowly over a period of time. If you or they have been exercising intensely, do not drink large quantities of plain water. In those instances, drink a beverage that will help restore electrolytes and sodium.

If someone becomes severely dehydrated so that they become confused, have severe headache, develop a fever, or lose consciousness, take them to an urgent care center. Under such conditions, intravenous administration of fluids might be necessary, and they should be carefully monitored. At Kathy’s Urgent Care, we’re ready to help.

Authored by Dr. Tom Brown