Water

The Underestimated Nutrient

Contributed by

Dr. Fay
Kazzi Shanholtzer
PhD, MS, RD

www.TheEarthyCanvas.com

A few facts about water probably pop into our mind — we need 8 cups of water a day, about 70-80% of our body is made of water, and most of the earth’s surface is covered with water.  We don’t usually think about water as an “essential nutrient.”  But it is just that.  It is essential that we drink water daily since it is required in amounts that exceed the body’s ability to produce it.  All chemical reactions need water to occur, water regulates body temperature, protects body organs and tissues, carries nutrients and oxygen to cells, acts as a vehicle to expel waste, and helps to form the structure of protein and glycogen molecules.  If it wasn’t for water we’d simply cease to exist.

With all the immense relevancy and importance of water, surprisingly there still appears to be some inconsistency in water research.  But what the literature tends to agree on is that dehydration, particularly chronic or long term dehydration, has been linked to many life threatening health outcomes which include the following (brace yourself for this laundry list!):  falls and fractures in the elderly, increased risk of heat stroke during heat waves, heart disease, bronchopulmonary disorders, kidney disease, urolithiasis, bladder and colon cancer, urinary tract infections, constipation, decreased salivation, dental carries, decreased immunity, and cataract formation or sight problems (1).

For quite some time the research on water was mainly supported by the bottled water industry, and as critical thinking scientists, we don’t really like research of this nature since some of these studies are biased and intend to produce results that favor the “product.”  Biased research can paint a fainter picture of methodical science on a particular topic and limits the dependability of conclusions drawn.  This is always important to keep in mind when looking at scarce data as it restricts the opportunity to compare and contrast studies.

How does drinking enough water per day really help me?

As I mentioned above, a lot of the research we have today on water come from more biased sources.  However, one of the best studies to date on the effects of adequate water consumption was conducted by the Adventist Health Study and included 20,000 subjects.  These were divided into two groups, one drank over 5 cups of water, the other less than 2 cups of water.  It was found that the group that drank over 5 cups of water per day were 50% less likely to get coronary heart disease than the group that only drank 2 or less cups of water per day (2).  It’s important to note that these results were estimated after controlling for other healthy behaviors like diet and exercise, so the water itself had health promoting effects.  The decrease in risk of heart disease may have had something to do with the viscosity of the blood with higher intake of water.  Of course, other aspects of the body can also benefit from improved circulation of the blood, so increased water can lend itself to overall health.  This is very powerful research because it produced results based on evidence and emphasized the effect of water in the absence of other healthy behaviors through the controlling process.

Where did this widely accepted 8 cups of water standard come from?

To reach a place where any “treatment” is being regularly prescribed by the medical community as a standard of care, there needs to be scores of evidenced-based sources to back it up.  But rather surprisingly the recommendation of drinking 8 cups of water per day stems back to a single 1920’s paper in which the author himself was the only subject enrolled in the study.  I’m not sure how biased that would have made it, but after calculating his own water expenditure (such as through urine and sweat), he found that approximately 8 Cups would replenish the lost stores of water one experiences in a day (4).

So how much water are we really supposed to have since this obviously isn’t the only source we should quote for a standard of care, right?  After much analysis of data, the medical authorities in Europe, the US Institute of Medicine and the World Health Organization finally recommended (not including fluids from food and other drinks) 4-7 Cups per day for women, and 6-11 Cups per day for men (2).  This does not take into consideration the water intake needs associated with regular or strenuous physical activity.  But I guess you could say Dr. Adolph was pretty close in his 1920’s paper with a single enrolled subject!

Behavioral health practices associated with low water consumption

Behavioral health practices have been shown to be strongly interconnected.  One behavior can influence and dictate the outcome of another.  If someone is diligent about daily exercise it’s not far-fetched to assume they may also eat a healthier diet than one who rarely ever exercises.  Healthy practices promote other healthy practices, and poor health practices tend to encourage other poor ones.

In a study analyzing the food behavioral practices of several thousand adults it was found that individuals who drank lower amounts of water were also involved in other unhealthy behaviors which included low fruit and vegetable intake and high fast-food intake.  The study concluded that understanding characteristics associated with low drinking water intake may help to identify populations that could benefit from targeted health interventions (2).  And if you think about it, who is most likely to drink more water?  Athletes and people who exercise more.  And so, it should not be surprising to see that those who drink more water overall also experience lower disease rates as this group is also practicing other beneficial behaviors that promote health and wellbeing.  The healthier behaviors we pick up the more likely we are to pick up more health behaviors until we are living a truly healthy and balanced lifestyle, so yes, every step in the right direction counts!

Does it make a difference whether I drink bottled water or tap water?

I’m very particular of the water I drink.  If I sense even the slightest off-taste or just that tiny bit of chlorine, I simply will not drink that water.  I’m not about to distrust my sense of taste and go right ahead and drink my water out of the tap either, after all, why would there be numerous water bottle companies if we could do just that?

This is a mindset that probably many of us have, but the research tends to show us some interesting findings.  A study analyzing the water from 35 water bottle companies did not guarantee higher quality, safer, or cleaner water than tap water (5).  Looks like just because water might come in the form of a pretty bottle with a sharp logo on it doesn’t make that much better than whatever is coming out of your tap.  I’m not recommending that you start drinking your tap water, but this is good drink for thought.

What about coconut water?  Is it really “glorified water?”

Cold coconut water out of the fridge can be so refreshing and delicious.  With its barely-there sweetness and tiny bits of coconut shreds along with the snazzy packaging promising invigorating electrolyte replenishment and an abundance of nutrients, it can make anyone feel like a health pro.  Unfortunately, mainstream media likes to blow things out of proportion in terms of benefits, and coconut water has been an easy and very marketable victim.

But what does the science tell us about the real benefits of drinking coconut water?  The truth is, it doesn’t provide any more benefit than a common sports drink would, aside from less sugar content.  A study conducted by the International Society of Sports Nutrition compared coconut water to regular manufactured sports drinks and found no difference between the two in terms of hydration or exercise performance.  Here’s the kicker though, those who drank the coconut water reported feeling more bloated and had more stomach upsets than those who were drinking the regular sports drinks (6).  Surprisingly, this study was funded by a coconut water manufacturing company!  It’s good to know that results were still published, though not in favor of its own product in comparison with a competitor.

How do we bottle up this whole water case?

If you want to keep your body hydrated and cleansed, drink your recommended amount of water daily.  Get most of your fluids from pure water.  Try to avoid sodas and caffeinated beverages, and even fruit juices (most are made from sugary concentrates).  If you get tired of drinking just water, infuse it with fresh fruit like strawberries, oranges, and lemons.  You can sweeten it naturally with stevia leaves and add a little more flare with fresh mint or rosemary.  If you want something hot, then have your water in the form of healing herbal teas like chamomile and mint.  Recently I’ve taken quite the liking to iced herbal tea, you just make yourself some hot herbal tea and then pour it over a cup full of ice.  I don’t even need to add any sweetener to it.  It is delightful and refreshing!  If you really want to have coconut water, then its best to have it fresh right out of the coconut, otherwise the bottled version may just be like buying expensive water.

Water is most definitely a gift from the Lord, we really don’t need to do much to it to reap its intended benefits.  Keeping it simple and consistent is the best attitude we can have in our hydration lifestyle. Cheers to going back to the basics, appreciating good research, and following simple recommendations for ultimate health!

References

  1. B Benelam, L Whyness. Hydration and health: a review. Nutrition Bulletin. 2010; 35:3-25
  2. Chan J, Knutsen SF, Blix GG, Lee JW, Fraser GE. Water, other fluids, and fatal coronary heart disease: the Adventist Health Study. Am J Epidemiol. 2002;155(9):827-833. doi:10.1093/aje/155.9.827
  3. Goodman AB, Blanck HM, Sherry B, Park S, Nebeling L, Yaroch AL. Behaviors and attitudes associated with low drinking water intake among US adults, Food Attitudes and Behaviors Survey, 2007. Prev Chronic Dis. 2013;10:E51. Published 2013 Apr 11. doi:10.5888/pcd10.120248
  4. Adolph EF. The regulation of the water content of the human organism. J Physiol. 1921;55(1-2):114-132. doi:10.1113/jphysiol.1921.sp001960
  5. Onufrak SJ, Park S, Sharkey JR, Sherry B. The relationship of perceptions of tap water safety with intake of sugar-sweetened beverages and plain water among US adults. Public Health Nutr. 2014;17(1):179-185. doi:10.1017/S1368980012004600
  6. Chan J, Knutsen SF, Blix GG, Lee JW, Fraser GE. Water, other fluids, and fatal coronary heart disease: the Adventist Health Study. Am J Epidemiol. 2002;155(9):827-833. doi:10.1093/aje/155.9.827