Hydration Nation!

Okay, what do hangovers, athletic performance, constipation, and headaches all have in common? You guessed it. Dehydration! Really. And the opposite of that is adequate hydration. All our bodily systems, including brain, muscles, heart, and digestion rely on good hydration to function well. 

So how much, really? Dr. Julian Seifter, a kidney specialist and associate professor of medicine at Harvard Medical School, recommends 30 to 50 ounces of water per day (about 1 to 1.5 liters), but not all at once. “The kidneys lose some ability to eliminate water as we age. It’s important to stay hydrated gradually, throughout the day drinking water or juices and eating water-rich foods,” he says. I recommend juicy fruits like watermelon, grapes, pears and plenty of veggies, which are loaded with water. Think about how juicy a tomato is, now picture a salad loaded with cherry tomatoes and cucumber. It’s a hydration salad. 

Although anyone can become dehydrated, most at risk are babies, young children, and the elderly. For children, the most common cause is prolonged diarrhea and vomiting. 

Symptoms in Infants or Young Children

• Dry mouth and tongue
• No tears when crying
• No wet diapers for three hours
• Sunken eyes, cheeks
• Sunken soft spot on top of skull
• Listlessness or irritability

The volume of water in the bodies of older adults is naturally lower, and there are other reasons they are prone to lack of fluids. “Older people don’t sense thirst as much as they did when they were younger. And that could be a problem if they’re on a medication that may cause fluid loss, such as a diuretic,” adds Dr. Seifter.

Symptoms in Adults

• Extreme thirst
• Less frequent urination
• Dark-colored urine
• Fatigue
• Dizziness
• Confusion

If you have an elder in your life be mindful that dehydration can cause dementia-like episodes. Setting a pitcher of water in a central area can be a good reminder to drink throughout the day– also a good way for caregivers to see how much has been consumed. Sparkling water or juices can make keeping intake up a little more interesting. Severe dehydration or kidney disease can be tested for with a serum BUN (blood urea nitrogen) test. This measures the amount of waste product in your blood. An abnormal count could mean that either your kidneys or your liver is not functioning properly–or that you are very dehydrated.

Call Your Healthcare Provider if You or a Loved One

• Has had diarrhea for 24 hours or more
• Is irritable or disoriented and much sleepier or less active than usual
• Can’t keep down fluids
• Has bloody or black stool

Tips to Staying Hydrated

• Can’t beat water. Drink throughout the day
• Dehydration can be confused with hunger – drink first
• Drink no-sugar-added juices and smoothies
• Tea and coffee do count
• Alcohol does not
• Add more soup to your meals
• Eat juicy fruits like grapefruit, oranges, strawberries, pineapple and cantaloupe  

More Tips from the ICU on Rehydrating

If you are caring for someone who has been vomiting:

• Don’t let them drink immediately after vomiting – wait at least ½ hour
• Mix up 1part water with 1part clear juice, such as apple or cranberry
• Then have the person sip from a teaspoon the watered-down juice
• This small amount of liquid will be absorbed in their mouth and esophagus and not make it to the stomach, reducing the likelihood of vomiting
• Wait another 10 minutes before providing another teaspoon
• Once the person has been able to keep down 5 teaspoons of fluid, you can switch over to tablespoons every 10 minutes
• Within 1-2 hours, the person will have taken in 4 ounces of fluids
• If they aren’t able to keep the watered juice down, then try again in 1 -2 hours 
• If they are still vomiting, then it’s time to see a health care provider

For Athletes 

We’ve all seen professional athletes, often runners and tennis players, succumb to cramping and other effects of dehydration. Intensive sports activity in hot weather requires taking in plenty of fluids before game time. 24 hours prior to vigorous exercise is the time to start the process. More than a quart of water can be lost in an hour of exercise depending on the temperature and intensity. 

When you sweat, you’re also losing some sodium and potassium, 2 electrolytes that also play a role in muscle function. A good way to monitor your hydration is to take a look at your urine. There should be plenty of it and it should be a pale yellow (unless you have taken vitamins, which can darken the color). 

During exercise, water is the best fluid, but sports drinks do help replace lost electrolytes if exercise is intense and lasts more than an hour. Adequate sodium levels can prevent hyponatremia (water intoxication) which has been known to happen to athletes who sweat out too much sodium and take in too much water.

Sports Recovery Drinks

Another great sports recovery drink that is gaining a lot of followers in professional, college and school sports is chocolate milk. There is plenty of water, plus protein to aid in muscle recovery, some glucose for quick energy and calcium for strong bones. 

Hot Yoga

Hot Yoga enthusiasts remind fellow yogis that they must hydrate before, during and after a class. Coconut water is the latest go–to beverage. It does contain some B vitamins and electrolytes including potassium (500mg), sodium and manganese. But the science does not provide evidence that it is better than plain water…if you’re thinking that you need more potassium, maybe add a few slices of banana to your cereal or yogurt.

Avoiding Constipation

The key to avoiding dehydration and all of the symptoms that go along with it, is to stay hydrated throughout the day. Consider starting your day with 2 glasses 8-12 oz each of water with some lemon juice. This helps get things started in the morning and can help you reach your goal of 30-50 ounces of water each day.

Keep a water bottle handy throughout the day and be sure to include fresh vegetables along with fruits.

Avoiding Hangovers

We think that the typical hangover headache is actually from dehydration. Here are a few tips:

• Alternate each alcoholic beverage with a full 8 oz glass of sparkling water

• Before a night of indulgence, do take a B complex vitamin as this has been shown in a few studies to reduce the “brain fogginess” after too much alcohol

• If you’ve had too much to drink, drink 2 glasses of water before going to bed and leave a water bottle on the night stand for the inevitable dry mouth.

• If you tend to get a headache after too many shots, beers, or glasses of wine, take 1-2 over the counter pain relievers with 2 big glasses of water before you go to bed, this can also help reduce dizziness.