2004
Study Examines the Question "Just How Much Water Do We Really
Need?"
Just
how much water do we really need? The answer may depend on our age
(February 24, 2004) BETHESDA, MD Just how much water
does each of us really need? Not to swim in, or diet with. Not to
respond to marketing claims, or counter salty foods or to cope with
dry environments.
Many
swear by the advice that for proper body hydration, 64 oz of water
should be consumed each day. Other scientists and researchers disagree
with that long held belief, recommending that one should only consume
water "when thirsty."
Why
should we be concerned? For one, water shortages may be the next
great crisis faced by a planet with limited natural resources and
exploding population growth. In March 2003, the United Nations issued
a report stating that more than 2.7 billion people will face severe
water shortages by the year 2025 if the world continues consuming
water at the same rate. Wars have erupted over water rights; famine
and mass starvation have resulted from climate changes that have
turned gardens into deserts. Soon we will all be concerned about
how much water we really need.
There
is no question that water is vital to the body's overall health.
We use water for transporting nutrients and wastes, lubrication,
temperature regulation, and tissue structure maintenance. In addition,
plentiful fluid consumption may be protective against diverse medical
conditions, including kidney stones, constipation, colorectal cancer,
premalignant adenomatous polyps, and bladder cancer. Water deprivation
results in life-threatening dehydration within a few days. Loss
of body water exceeding five percent of body weight leads to decreased
endurance, culminating in heat exhaustion. Older vs. younger individuals
have been shown to have a higher risk of developing dehydration
than younger adults, which may be attributed to decreased total
body water (TBW) with age, impaired renal fluid conservation, and
physiological hypodipsia or insensible thirst.
Despite
the physiological importance of water to life, little is known about
water intake and excretion patterns in free-living individuals,
because fluid intake, particularly from noncaloric, nonalcoholic,
and noncaffeinated beverages is poorly documented. The 1977-1978
National Food Consumption Survey is one of the few sources of information
on water intake, but the data are limited by unaccounted for water
found in foods and the use of a single 24-hour dietary recall. Moreover,
nonquantitative intake from water fountains and the likelihood that
many people consume fluids with little thought leads to underreporting.
One
method that does not depend on self-reported intake is the use of
hydrogen-labeled water turnover, a method used by comparative animal
physiologists for decades to objectively measure water turnover
in wild animals. The procedure begins with a bolus administration
of isotopically labeled water, such as nonradioactive 2H oxide.
Within two to three hours, this tracer equilibrates with body water
and provides a measure of the volume of the TBW pool. The labeled
water is then excreted from the body through all routes of water
loss and is diluted by unlabeled water through all routes of input.
The time course of labeled water dilution provides a measure of
water turnover (input and output) per unit of time.
A New
Study
A new
study combined data from two studies in healthy, free-living American
adults across a broad age range to which 2H-labeled water was administered
to measure total energy expenditure (TEE) using the doubly labeled
water (DLW) technique. In one of these studies, two 24-hour urine
collections were made from many of these same participants using
p-aminobenzoic acid (PABA) to confirm completeness.
The
data obtained are among the first objective assessment of water
turnover in American adults and provide documentation of both the
average and range of water input and urine production.
This
study, "Water Turnover in 458 American Adults 40-79 Years of
Age," is a collaborative effort by Aarthi Raman and Dale A.
Schoeller from the Department of Nutritional Sciences, University
of Wisconsin-Madison, Madison, WI; from divisions of the National
Institutes of Health in Bethesda, MD, are Amy F. Subar and Richard
P. Troiano (Division of Cancer Control and Population Sciences,
Applied Research Program); Arthur Schatzkin, (Division of Cancer
Epidemiology and Genetics, Nutritional Epidemiology Branch, National
Cancer Institute); Tamara Harris and Douglas Bauer (National Institute
on Aging); and James E. Everhart (National Institute of Diabetes
and Digestive and Kidney Diseases). Additional participants include
Shiela A. Bingham, at the MRC-Dunn Human Nutrition Unit, Cambridge,
United Kingdom; Anne B. Newman, at the Division of Geriatric Medicine,
University of Pittsburgh, Pittsburgh, PA; and Frances A. Tylavsky
from the Department of Preventive Medicine, University of Tennessee,
Memphis, TN. Their findings appear in the February 2004 issue of
the American Journal of Physiology--Renal Physiology.
Methodology
Despite
recent interest in water intake, few data are available on water
metabolism in adults. To determine the average and range of usual
water intake, urine output, and total body water, the researchers
administered 2H oxide to 458 noninstitutionalized 40- to 79-yr-old
adults living in temperate climates. Urine was collected in a subset
of individuals (n = 280) to measure 24-hour urine production using
p-aminobenzoic acid to ensure complete collection. Preformed water
intake was calculated from isotopic turnover and corrected for metabolic
water and insensible water absorption from humidity.
Results
Preformed
water intake, which is water from beverages and food moisture, averaged
3.0 l (liters)/day in men (range: 1.4-7.7 l/day) and 2.5 l/day in
women (range: 1.2-4.6 l/day). Preformed water intake was lower in
the 70-79 age group (2.8 l/day) than in 40- to 49-yr-old men, and
was lower in older age group (2.3 l/day) than in 40- to 49- and
50- to 59-year-old women. Urine production averaged 2.2 l/day in
men (range: 0.6-4.9 l/day) and 2.2 l/day in women (0.9-6.0 l/day).
Other results indicated no age-related differences in women, but
men 60-69 years old had significantly higher urine output than 40-
to 49- and 50- to 59-year-old men. Additionally, only the 70- to
79-year-old age group included sufficient blacks for a racial analysis.
Blacks in this age group showed significantly lower preformed water
intake than did whites. Whites had significantly higher water turnover
rates than blacks as well.
Conclusions
These
results demonstrate that water turnover is highly variable among
individuals and that little of the variance is explained by anthropometric
parameters. A key aim of this research was to test whether the elderly
had low intakes of water that might predispose them to chronic dehydration.
The results found that, on average, the oldest group of individuals
had a preformed water intake that was 98 percent of the younger
group of individuals when expressed per kilocalorie of energy expended.
There was no evidence of dehydration in the 70- to 79-year-old group,
despite the majority of the individuals having intakes less than
the commonly used suggestion of eight 8-oz glasses of water each
day. Furthermore, recommendations to increase fluid intake to eight
8-oz glasses of water in the elderly may not be prudent because
the elderly have an elevated risk of overhydration due to the weakened
physiological movement of water through the system. Instead, the
researchers suggest that fluid intake for the elderly be increased
during periods of acute thermal stress.
###
Source:
February 2004 edition of the American Journal of Physiology--Renal
Physiology.
The
American Physiological Society (APS) was founded in 1887 to foster
basic and applied science, much of it relating to human health.
The Bethesda, MD-based Society has more than 10,000 members and
publishes 3,800 articles in its 14 peer-reviewed journals every
year.
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