Got Water?

Other than pelvic health and sex, my favorite conversation topic is cats water! Yes, good old H-2-O! You may recall a post I did a while back that discussed how diet can play a role in pelvic health. I talked about the importance of water intake, but patients still ask me questions about this topic. A majority of people report that they are not drinking enough water. Many patients ask if soda, coffee, juice and a myriad of other food and beverages count towards their water intake. While my gut reaction to these queries has always been an emphatic “NO!” I never checked to see if my instincts were correct. For this post, I decided to dive in and see if I can quench the questions surrounding water intake.

Water comprises about 60% of a human’s body weight, so it goes without saying that water is is vital to our health. Some of the ways water helps our bodies function include:

• Transporting other nutrients within the body
• Filtering out waste through urine, sweat and feces
• Maintaining homeostasis
• Keeping joints well lubricated
• Providing structure to cells and tissues
• Helping to preserve cardiovascular function
• Supporting bowel function

So, do milk, coffee, and juice count as water? Sort of. Your body absorbs a small percentage of water from (almost) everything you ingest. If you want to have a wild Saturday night, you can check out the USDA’s website which allows you to search for food composition by nutrient! Did you know that a slice of cheese pizza is roughly 42% water? A cup of chocolate frozen yogurt is about 70% water. (Finally, a diet I can get behind!) But there is only one thing that contains 100% water: WATER! Shocking right?

While fruit juice and other beverages can contain around 85% water, they can also contain a large amount of sugar and calories. With the rise of obesity and Type 2 Diabetes, these beverages should be consumed in moderation. Furthermore, The Center for Disease Control and Prevention (CDC) report that sugar-sweetened beverages are also associated with heart disease, kidney disease, tooth decay and gout.

Ok, we get it. Sugar is bad. What about coffee?

Coffee is comprised primarily of water, but for people who suffer from painful bladder syndrome/interstitial cystitis, coffee and other acidic beverages can irritate their symptoms. Water, on the other hand, has a neutral pH, so it does not irritate the bladder. Coffee also contains caffeine, which can make one feel jittery or anxious and in large amounts it can contribute to sleep dysfunction.

By now, you may have realized that I really like straight-from-the-tap water. Hopefully you want to join me in drinking the kool-aid water, but you may be asking yourself — how much water do I really need?

The amount of water a body needs varies from one person to the next, so the “8 glass per day” maximum is misleading. Here at PHRC we aren’t fans of cookie cutter medicine, therefore we don’t believe in “one-size-fits-all” dietary recommendations. The amount of water an individual needs varies based on several factors, namely:

• Gender
• Body weight/height
• Activity level
• Other health factors (Diabetes, chemotherapy, etc.)
• Pregnancy and breastfeeding

In general, the Institute of Medicine recommends that adult women consume 2700 ml per day, and that adult men consume 3700 ml per day. These figures include water that is absorbed from other beverages and food, but remember that only water will provide the body with 100% water. This recommendation is also based on a “sedentary person in a temperate climate.”

Some people, including fellow Physical Therapist and nutrition expert Jessica Drummond, recommend one’s daily water intake should be half one’s body weight. So if you are 200 pounds, you should drink 100 ounces a day.

If you exercise, your body will require more water to replenish itself. The same is true if you travel somewhere hot and humid, so if you decide to run a half marathon in the tropics, be prepared to increase your water intake!

Dehydration can impair cognitive performance. Research shows even a loss of 1% body water can have a negative impact on cognition. It can also contribute to decreased physical performance. Staying hydrated may help prevent certain illnesses, especially those involving the kidneys, which work hard to rid the body of waste. Drinking enough water can help prevent kidney/bladder stones and it may protect against chronic kidney disease (CKD).

The kidneys aren’t the only organ that can be impacted by insufficient water consumption. There is evidence that adequate fluid intake can help prevent exercise induced asthma. Additionally, hypohydration can contribute to constipation; if you follow this blog, you know that bowel health is important for a happy pelvic floor.

A water deficit can also negatively impact a person’s mood and energy levels. In one study, individuals with mild dehydration were found to report fatigue, confusion and anger. So before you start blaming your bad mood on being hangry, grab a glass of water.

Not a fan of drinking plain water? Try adding a slice of lemon, or make yourself feel like you are at the spa by adding cucumber and mint. You could make it even more fun by adding a crazy straw! Remember, while everything we eat does contain some percentage of water and contributes to overall fluid intake, it can’t replace plain, natural water. It’s vegan, gluten free, zero calorie and all around awesome. Whatever it takes, drink up and your body will thank you!

References:

1. Popkin, Barry M., Kristen E. D’Anci, and Irwin H. Rosenberg. “Water, Hydration and Health.” Nutrition reviews 68.8 (2010): 439–458. PMC. Web. 24 Apr. 2018.
2. Leahy M, Ratliff JC, Riedt CS, Fulgoni VL, III. Consumption of Low-Calorie Sweetened Beverages Compared to Water Is Associated with Reduced Intake of Carbohydrates and Sugar, with No Adverse Relationships to Glycemic Responses: Results from the 2001–2012 National Health and Nutrition Examination Surveys. Nutrients. 2017; 9(9):928.
3. Daniels, Melissa C., and Barry M. Popkin. “The Impact of Water Intake on Energy Intake and Weight Status: A Systematic Review.” Nutrition reviews 68.9 (2010): 505–521. PMC. Web. 24 Apr. 2018.
4. https://www.cdc.gov/nutrition/data-statistics/plain-water-the-healthier-choice.html
5. http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=10925
6. Riebl SK, Davy BM. The Hydration Equation: Update on Water Balance and Cognitive Performance. ACSM’s health & fitness journal. 2013;17(6):21-28. doi:10.1249/FIT.0b013e3182a9570f.
7. D’anci KE, Vibhakar A, Kanter JH, Mahoney CR, Taylor HA. Voluntary dehydration and cognitive performance in trained college athletes. Percept Mot Skills. 2009 Aug; 109(1):251-69.
8. Sontrop JM, Dixon SN, Garg AX, Buendia-Jimenez I, Dohein O, Huang SH, Clark WF (2013) Association between water intake, chronic kidney disease, and cardiovascular disease: a cross-sectional analysis of NHANES data. Am J Nephrol 37:434–442
9. Ahluwalia, Namanjeet, and Kirsten Herrick. “Caffeine Intake from Food and Beverage Sources and Trends among Children and Adolescents in the United States: Review of National Quantitative Studies from 1999 to 2011.” Advances in Nutrition 6.1 (2015): 102–111. PMC. Web. 24 Apr. 2018.